The free vastus lateralis-And conjoined vastus lateralis anterolateral thigh/tensor fascia lata flap for oncological chest wall reconstruction.

Autor: Falkner F; Department of Hand, Plastic and Reconstructive Surgery, Burn Center, BG Center Ludwigshafen, Ludwigshafen, Germany.; Department of Hand and Plastic and Surgery, Heidelberg University, Heidelberg, Germany., Thomas B; Department of Hand, Plastic and Reconstructive Surgery, Burn Center, BG Center Ludwigshafen, Ludwigshafen, Germany.; Department of Hand and Plastic and Surgery, Heidelberg University, Heidelberg, Germany., Mayer SA; Department of Hand, Plastic and Reconstructive Surgery, Burn Center, BG Center Ludwigshafen, Ludwigshafen, Germany.; Department of Hand and Plastic and Surgery, Heidelberg University, Heidelberg, Germany., Didzun O; Department of Hand, Plastic and Reconstructive Surgery, Burn Center, BG Center Ludwigshafen, Ludwigshafen, Germany.; Department of Hand and Plastic and Surgery, Heidelberg University, Heidelberg, Germany., Knoedler L; Department of Hand, Plastic and Reconstructive Surgery, Burn Center, BG Center Ludwigshafen, Ludwigshafen, Germany.; Department of Hand and Plastic and Surgery, Heidelberg University, Heidelberg, Germany., Panayi AC; Department of Hand, Plastic and Reconstructive Surgery, Burn Center, BG Center Ludwigshafen, Ludwigshafen, Germany.; Department of Hand and Plastic and Surgery, Heidelberg University, Heidelberg, Germany., Hundeshagen G; Department of Hand, Plastic and Reconstructive Surgery, Burn Center, BG Center Ludwigshafen, Ludwigshafen, Germany.; Department of Hand and Plastic and Surgery, Heidelberg University, Heidelberg, Germany., Vollbach FH; Department of Hand, Plastic and Reconstructive Surgery, Burn Center, BG Center Ludwigshafen, Ludwigshafen, Germany.; Department of Hand and Plastic and Surgery, Heidelberg University, Heidelberg, Germany.; Division of Hand, Plastic and Aesthetic Surgery, Ludwig-Maximilians-University (LMU), Munich, Germany., Gazyakan E; Department of Hand, Plastic and Reconstructive Surgery, Burn Center, BG Center Ludwigshafen, Ludwigshafen, Germany.; Department of Hand and Plastic and Surgery, Heidelberg University, Heidelberg, Germany., Kneser U; Department of Hand, Plastic and Reconstructive Surgery, Burn Center, BG Center Ludwigshafen, Ludwigshafen, Germany.; Department of Hand and Plastic and Surgery, Heidelberg University, Heidelberg, Germany., Bigdeli AK; Department of Hand, Plastic and Reconstructive Surgery, Burn Center, BG Center Ludwigshafen, Ludwigshafen, Germany.; Department of Hand and Plastic and Surgery, Heidelberg University, Heidelberg, Germany.
Jazyk: angličtina
Zdroj: Microsurgery [Microsurgery] 2024 Sep; Vol. 44 (6), pp. e31212.
DOI: 10.1002/micr.31212
Abstrakt: Introduction: A reconstructive option for extensive chest wall reconstruction is the free myocutaneous vastus lateralis muscle (VL) flap which can be performed in isolation or in conjunction with a fasciocutaneus anterolateral thigh (cVLALT) and/or myofasciocutaneous tensor fascia lata flap (cVLTFL). We aimed to directly compare the outcomes of these reconstructive options.
Methods: Patients who underwent oncological chest wall reconstruction with a free VL, cVLALT, or cVLTFL flap between February 2010 and 2022 were included in this retrospective study. Patient demographics, surgical characteristics, as well as medical and reconstructive outcomes, were evaluated. The operative outcomes between myocutaneous VL, cVLALT, and cVLTFL flap reconstructions were compared.
Results: A total of 41 patients underwent chest wall reconstruction with a free myocutaneous VL (n = 25; 61%), cVLALT (n = 14; 34%), or cVLTFL Three acute flap thromboses occurred in the entire cohort (3/41, 7%), with one myocutaneous VL flap failing because of recurrent venous thrombosis during the salvage procedure. Total flap necrosis was seen in two cases (5%; VL flap: n = 1; cVLALT flap: n = 1), and partial flap necrosis in one VL flap (1/25, 4%) and in the distal ALT portion of three cVLALT flaps (3/14, 21%). No significant difference was seen between isolated VL and conjoined VL flaps regarding the partial (p = .28) or total flap necrosis rate (p = .9).
Conclusion: The free (conjoined) VL flap provides reliable outcomes for obliterating dead space achieving durable reconstruction of complex chest wall defects.
(© 2024 Wiley Periodicals LLC.)
Databáze: MEDLINE
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