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Muscle versus Fasciocutaneous Free Flaps in Lower Extremity Traumatic Reconstruction: A Multicenter Outcomes Analysis.

Publication ,  Journal Article
Cho, EH; Shammas, RL; Carney, MJ; Weissler, JM; Bauder, AR; Glener, AD; Kovach, SJ; Hollenbeck, ST; Levin, LS
Published in: Plastic and reconstructive surgery
January 2018

Clinical indications are expanding for the use of fasciocutaneous free flaps in lower extremity traumatic reconstruction. The authors assessed the impact of muscle versus fasciocutaneous free flap coverage on reconstructive and functional outcomes.A multicenter retrospective review was conducted on all lower extremity traumatic free flaps performed at Duke University (1997 to 2013) and the University of Pennsylvania (2002 to 2013). Muscle and fasciocutaneous flaps were compared in two subgroups (acute trauma and chronic traumatic sequelae), according to limb salvage, ambulation time, and flap outcomes.A total of 518 lower extremity free flaps were performed for acute traumatic injuries (n = 238) or chronic traumatic sequelae (n = 280). Muscle (n = 307) and fasciocutaneous (n = 211) flaps achieved similar cumulative limb salvage rates in acute trauma (90 percent versus 94 percent; p = 0.56) and chronic trauma subgroups (90 percent versus 88 percent; p = 0.51). Additionally, flap choice did not impact functional recovery (p = 0.83 for acute trauma; p = 0.49 for chronic trauma). Flap groups did not differ in the rates of flap thrombosis, flap salvage, flap loss, or tibial nonunion requiring bone grafting. Fasciocutaneous flaps were more commonly reelevated for subsequent orthopedic procedures (p < 0.01) and required fewer secondary skin-grafting procedures (p = 0.01). Reconstructive and functional outcomes remained heavily influenced by injury severity.Muscle and fasciocutaneous free flaps achieved comparable rates of limb salvage and functional recovery. Flap selection should be guided by defect characteristics and reconstructive needs.Therapeutic, III.

Duke Scholars

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Published In

Plastic and reconstructive surgery

DOI

EISSN

1529-4242

ISSN

0032-1052

Publication Date

January 2018

Volume

141

Issue

1

Start / End Page

191 / 199

Related Subject Headings

  • Young Adult
  • Wound Healing
  • Treatment Outcome
  • Surgery
  • Soft Tissue Injuries
  • Skin Transplantation
  • Risk Assessment
  • Retrospective Studies
  • Plastic Surgery Procedures
  • Myocutaneous Flap
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Cho, E. H., Shammas, R. L., Carney, M. J., Weissler, J. M., Bauder, A. R., Glener, A. D., … Levin, L. S. (2018). Muscle versus Fasciocutaneous Free Flaps in Lower Extremity Traumatic Reconstruction: A Multicenter Outcomes Analysis. Plastic and Reconstructive Surgery, 141(1), 191–199. https://doi.org/10.1097/prs.0000000000003927
Cho, Eugenia H., Ronnie L. Shammas, Martin J. Carney, Jason M. Weissler, Andrew R. Bauder, Adam D. Glener, Stephen J. Kovach, Scott T. Hollenbeck, and L Scott Levin. “Muscle versus Fasciocutaneous Free Flaps in Lower Extremity Traumatic Reconstruction: A Multicenter Outcomes Analysis.Plastic and Reconstructive Surgery 141, no. 1 (January 2018): 191–99. https://doi.org/10.1097/prs.0000000000003927.
Cho EH, Shammas RL, Carney MJ, Weissler JM, Bauder AR, Glener AD, et al. Muscle versus Fasciocutaneous Free Flaps in Lower Extremity Traumatic Reconstruction: A Multicenter Outcomes Analysis. Plastic and reconstructive surgery. 2018 Jan;141(1):191–9.
Cho, Eugenia H., et al. “Muscle versus Fasciocutaneous Free Flaps in Lower Extremity Traumatic Reconstruction: A Multicenter Outcomes Analysis.Plastic and Reconstructive Surgery, vol. 141, no. 1, Jan. 2018, pp. 191–99. Epmc, doi:10.1097/prs.0000000000003927.
Cho EH, Shammas RL, Carney MJ, Weissler JM, Bauder AR, Glener AD, Kovach SJ, Hollenbeck ST, Levin LS. Muscle versus Fasciocutaneous Free Flaps in Lower Extremity Traumatic Reconstruction: A Multicenter Outcomes Analysis. Plastic and reconstructive surgery. 2018 Jan;141(1):191–199.

Published In

Plastic and reconstructive surgery

DOI

EISSN

1529-4242

ISSN

0032-1052

Publication Date

January 2018

Volume

141

Issue

1

Start / End Page

191 / 199

Related Subject Headings

  • Young Adult
  • Wound Healing
  • Treatment Outcome
  • Surgery
  • Soft Tissue Injuries
  • Skin Transplantation
  • Risk Assessment
  • Retrospective Studies
  • Plastic Surgery Procedures
  • Myocutaneous Flap