{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T12:01:38Z","timestamp":1791979298138,"version":"4.4.0"},"reference-count":39,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2022,4,25]],"date-time":"2022-04-25T00:00:00Z","timestamp":1650844800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Objective: To evaluate donor site morbidity of the serratus anterior free flap (SAFF) in head and neck reconstruction. Methods: The Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire (0 no disability to 100 most severe disability) was applied to 20 patients (M: 16; F: 4) who underwent ablative surgery and reconstruction of the head and neck using a SAFF. Applications, as well as the donor site, recipient site and flap-related complications, were evaluated. Results: SAFF was mainly used for tongue (n = 11; 55.0%) and pharyngeal reconstruction after a laryngopharyngectomy (n = 4; 20.0%). The majority of patients presented with stage IV disease (n = 12; 60%) and had undergone previous radiotherapy (n = 14; 70%). Our free flap survival rate was 88.9% and the pectoralis major muscle flap (PMMF) was used in 5 patients as a salvage option to reconstruct pharyngeal defects. The mean\/median DASH score was 21.6\/19.9 (healthy norm 10.1), indicating only mild to moderate disability. However, free flap failure and the additional harvest of PMMF multiplies donor site morbidity since it was associated with a 3- and 2.6-times higher DASH score (46.0 vs. 15.5; p = 0.039 and 39.9 vs. 15.47; p = 0.081). Conclusions: The SAFF represents a versatile flap for head and neck reconstruction with low donor site morbidity.<\/jats:p>","DOI":"10.3390\/jcm11092397","type":"journal-article","created":{"date-parts":[[2022,4,25]],"date-time":"2022-04-25T21:16:28Z","timestamp":1650921388000},"page":"2397","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Using the DASH Questionnaire to Evaluate Donor Site Morbidity of the Serratus Anterior Free Flap in Head and Neck Reconstruction: A Multicenter Study"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1161-4871","authenticated-orcid":false,"given":"Stefan","family":"Janik","sequence":"first","affiliation":[{"name":"Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julian","family":"Pyka","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9055-8523","authenticated-orcid":false,"given":"Muhammad","family":"Faisal","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology, Shaukat Khanum Memorial Cancer Hospital, Lahore 54000, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"Grasl","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3937-5315","authenticated-orcid":false,"given":"Pawel","family":"Golusinski","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology and Maxillofacial Surgery, University of Zielona Gora, 65-046 Zielona Gora, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6094-7114","authenticated-orcid":false,"given":"Bla\u017een","family":"Mariji\u0107","sequence":"additional","affiliation":[{"name":"Institute of Head and Neck Diseases, Evangelical Hospital, 1180 Vienna, Austria"},{"name":"Department of Otorhinolaryngology, Head and Neck Surgery, Clinical Hospital Center Rijeka, Faculty of Medicine, University of Rijeka, 51000 Rijeka, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rudolf","family":"Seemann","sequence":"additional","affiliation":[{"name":"Institute of Head and Neck Diseases, Evangelical Hospital, 1180 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5706-1056","authenticated-orcid":false,"given":"Boban M.","family":"Erovic","sequence":"additional","affiliation":[{"name":"Institute of Head and Neck Diseases, Evangelical Hospital, 1180 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,4,25]]},"reference":[{"key":"ref_1","unstructured":"Buncke, H., Alpert, B., and Gordon, L. 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