Summary
Background
Whilst soft tissue closure is the priority to prevent infection in open fractures
of the lower limb, some patients find that bulky flaps interfere with function and
dislike the appearance. We report the outcomes of delayed free anterolateral thigh
flap thinning with liposuction.
Material and methods
38 patients treated between 2006 and 2009 were offered flap contouring. 23 chose flap
thinning and 15 did not. We measured outcomes using the SF-36v2 questionnaire and
cosmetic outcome scores pre and postoperatively at a mean follow up of 12 weeks (range
10–16 weeks).
Results
SF-36v2 physical health (PH) scores improved from a mean of 67 preoperatively to 80
postoperatively (p = 0.01) in the thinned group, while mental health (MH) scores remained unchanged
(74–72). The mean SF-36v2 scores for the non-thinned group were 77 (PH) and 86 (MH).
Following liposuction the median cosmetic outcome scores out of 5 improved from 1
(not at all satisfied) to 4 (very satisfied) postoperatively (p = 0.0005), which was also higher than the non-thinned group (3) [moderately satisfied],
p = 0.004). There was no difference in sex, age, BMI and region on the leg of free
flap reconstruction between the non-thinned and thinned groups.
Conclusions
Delayed contouring of free ALT flaps used for lower limb reconstruction results in
improvements in physical health measures and cosmetic outcomes. Patients not requesting
thinning are generally satisfied with their reconstruction.
Keywords
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Article info
Publication history
Published online: November 28, 2011
Accepted:
November 6,
2011
Received:
August 12,
2011
Identification
Copyright
© 2011 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Inc. All rights reserved.
