Recurrent hidradenitis suppurativa; will take skin graft fro | Figure 1

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Recurrent hidradenitis suppurativa; will take skin graft from left anterior thigh for left axillary and bilateral groin.

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Why you should join Figure 1

Grafts for preventing Frey's syndrome after surgery to the parotid (salivary) glands

Review question
Does the use of a graft during surgery to the parotid glands prevent Frey's syndrome?
Background
The clinical symptoms of Frey's syndrome include sweating and flushing of the cheek when eating and chewing. It results from abnormal regrowth of damaged autonomic nerve fibres of the parotid glands, for example during surgery for parotid gland tumours. It is unclear whether placing a graft between the skin flap and the parotid bed during surgery can prevent this syndrome. Various types of grafts can be used, including biomaterial or skin, muscle or other tissue from the patient. These grafts may possibly hinder the abnormal connections of the nerves controlling the sweat glands and parotid glands when the cut nerves are re‐linking after surgery.
Study characteristics
We included three studies with 124 participants in this review, but the quality of these studies was not ideal. All of the participants in the studies had tumours of the parotid glands and were undergoing surgery to part of the glands. The studies assessed two types of grafts, tissue obtained from the sternocleidomastoid muscle and a biomaterial (a collagen framework without cells).
Key results
Two studies compared a tissue graft obtained from the sternocleidomastoid muscle to no graft. It is not known whether this type of tissue graft can prevent Frey's syndrome because the available evidence is very uncertain. One study compared a biomaterial graft to no graft. This type of graft may result in little or no difference to the incidence rate of Frey's syndrome, but the evidence is very uncertain. It may make the patient's wound slightly more likely to become infected.
Certainty of the evidence
The evidence in this review is mostly of low or very low certainty, because of the small number of studies on this question and the risk of bias in these studies. The findings must therefore be treated with caution and further studies are needed to draw reliable conclusions. The evidence in this review is up to date to 5 February 2019.

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