Outcome comparison between muscle and fasciocutaneous flaps after secondary orthopedic procedures.

Autor: Guo M; Department of Plastic Surgery, The Medical College of Wisconsin, Milwaukee, WI., Thomas B; Department of Plastic Surgery, The Medical College of Wisconsin, Milwaukee, WI., Goyal S; Department of Plastic Surgery, The Medical College of Wisconsin, Milwaukee, WI., Rivedal D; Department of Plastic Surgery, The Medical College of Wisconsin, Milwaukee, WI., Mehdi M; Department of Plastic Surgery, The Medical College of Wisconsin, Milwaukee, WI., Schmeling GJ; Department of Orthopaedic Surgery, The Medical College of Wisconsin, Milwaukee, WI., Neilson JC; Department of Orthopaedic Surgery, The Medical College of Wisconsin, Milwaukee, WI., Martin J; Department of Orthopaedic Surgery, The Medical College of Wisconsin, Milwaukee, WI., Harkin EA; Department of Orthopaedic Surgery, The Medical College of Wisconsin, Milwaukee, WI., Wooldridge A; Department of Orthopaedic Surgery, The Medical College of Wisconsin, Milwaukee, WI., King DM; Department of Orthopaedic Surgery, The Medical College of Wisconsin, Milwaukee, WI., Hackbarth DA Jr; Department of Orthopaedic Surgery, The Medical College of Wisconsin, Milwaukee, WI., Doren EL; Department of Plastic Surgery, The Medical College of Wisconsin, Milwaukee, WI., Hettinger P; Department of Plastic Surgery, The Medical College of Wisconsin, Milwaukee, WI., LoGiudice JA; Department of Plastic Surgery, The Medical College of Wisconsin, Milwaukee, WI; Department of Orthopaedic Surgery, The Medical College of Wisconsin, Milwaukee, WI. Electronic address: jlogiudice@mcw.edu.
Jazyk: angličtina
Zdroj: Journal of plastic, reconstructive & aesthetic surgery : JPRAS [J Plast Reconstr Aesthet Surg] 2023 Feb; Vol. 77, pp. 111-116. Date of Electronic Publication: 2022 Nov 23.
DOI: 10.1016/j.bjps.2022.11.036
Abstrakt: Lower extremity wounds associated with fractures and bony defects often require secondary orthopedic procedures after flap coverage has been performed. In this study, we compare complications between muscle and fasciocutaneous flaps after secondary orthopedic procedures. A retrospective chart review study of all lower extremity soft tissue reconstructions by a single surgeon over seven years yielded a subgroup of patients who underwent secondary orthopedic procedures, including hardware removal, hardware revision, and bone grafting after flap reconstruction. Of 355 lower extremity, soft tissue reconstructions for orthopedic coverage performed in the time period studied, 102 patients underwent secondary orthopedic procedures after flap reconstruction. Of these, 54 received muscle flaps (52.94%), and 48 received fasciocutaneous flaps (47.06%). Using this subgroup of 102 patients, we compared muscle and fasciocutaneous flaps using three categories of wound complications following these secondary procedures: There were no superficial wounds requiring local wound care only in the muscle flap group (0%, n = 0) versus 4.17% (n = 2; p = 0.130) in the fasciocutaneous flap group. There were 2 lost flaps requiring surgical debridement and additional skin grafting in the muscle flaps group (3.70%) versus 2 (4.17%; p = 0.904) in the fasciocutaneous flap group. In the third category, flap loss requiring additional soft tissue reconstruction was 18.52% (n = 10) in the muscle group versus 2.08% (n = 1; p = 0.008) in the fasciocutaneous flap group. Our data support the existing literature indicating that fasciocutaneous flaps can tolerate secondary procedures better than muscle flaps and should initially be considered in patients with higher probability of needing additional orthopedic procedures after reconstruction.
Competing Interests: Potential conflicts of interest The authors have no conflicts of interest relevant to this article to disclose.
(Copyright © 2022 British Association of Plastic, Reconstructive and Aesthetic Surgeons. All rights reserved.)
Databáze: MEDLINE
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