Effect of microporous polysaccharide hemospheres on anterolateral thigh free flap donor site complications

Background Postoperative seroma is the most common donor site complication following anterolateral thigh (ALT) free flap harvest for head and neck reconstruction. The utility of novel microporous polysaccharide hemospheres (MPH) has not been studied as a hemostatic agent in this setting. Methods Prospective, single-blind, randomized controlled trial of patients undergoing fasciocutaneous ALT harvest for head and neck reconstruction at a tertiary academic medical center between April 2018 and February 2020. The intervention (MPH) group received 3 g of topical MPH to the ALT donor site prior to closure whereas the control group did not receive application of MPH. Outcomes included total drain output (ml), drain output during postoperative days (POD) 1-3 alone, drain duration (days), and incidence of donor site hematoma, seroma, or infection. Results Twenty-nine patients were randomized to the MPH group and 26 to the control group. For MPH and control groups, mean total drain output was 284.7 +/- 153.0 ml versus 317.9 +/- 177.6 ml (p = .527), mean POD 1-3 drain output alone was 169.3 +/- 88.8 ml versus 157.9 +/- 78.7 ml (p = .749), and drain duration was 5.9 +/- 1.5 days versus 6.5 +/- 1.6 days (p = .144), respectively. There was no significant difference in seroma (p = .733), hematoma (p = .492), or infection (p = 1.000). Drain output was not significantly influenced by gender, age, body weight, or smoking habits. Conclusion MPH administration to ALT free flap donor sites did not significantly improve drain output, hematoma formation, or seroma formation. Level of Evidence 2