Free Fasciocutaneous versus Muscle Flaps in Lower Extremity Reconstruction: Implications for Functionality and Quality of Life.

IF 2.2 3区 医学 Q2 SURGERY Journal of reconstructive microsurgery Pub Date : 2024-12-20 DOI:10.1055/a-2483-5388
Emile B List, Brett A Hahn, Shan S Qiu, Tim de Jong, Hinne A Rakhorst, Elfi M Verheul, Wiesje Maarse, J Henk Coert, David D Krijgh
{"title":"Free Fasciocutaneous versus Muscle Flaps in Lower Extremity Reconstruction: Implications for Functionality and Quality of Life.","authors":"Emile B List, Brett A Hahn, Shan S Qiu, Tim de Jong, Hinne A Rakhorst, Elfi M Verheul, Wiesje Maarse, J Henk Coert, David D Krijgh","doi":"10.1055/a-2483-5388","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong> Free tissue transplantations are commonly used to treat complex lower extremity defects caused by trauma, vascular disease, or malignancy, particularly when vital structures are exposed. This study aimed to expand the knowledge on patient-reported outcomes by comparing fasciocutaneous and muscle flaps, with the goal of facilitating patient counseling. Additionally, patient-level risk factors associated with decreased functioning and health-related quality of life were identified.</p><p><strong>Methods: </strong> This retrospective, cross-sectional, multicenter study included patients who underwent microsurgical lower extremity reconstruction using free fasciocutaneous or muscle flaps between 2003 and 2021, with a minimum follow-up of 12 months. Data were collected from medical records, pain scores, Short-Form 36 (SF-36), and Lower Extremity Functional Scale (LEFS). Mean scores were compared between flap types and predictors of LEFS, SF-36 mental component summary (MCS), and SF-36 physical component summary (PCS) scores were determined using a backward stepwise regression model.</p><p><strong>Results: </strong> Of the 206 patients eligible, 100 (49%) were included in the retrospective part. A total of 89 (43%) responded to the questionnaires, with 62 treated using a fasciocutaneous flap and 27 with a muscle flap. No significant differences in total LEFS, SF-36 PCS, or MCS scores were found between the two flap type. Pain was a significant predictor of decreased functional outcomes for both flap types and was also linked to poorer mental health in patients treated with fasciocutaneous flaps. Other predictors of low patient-reported outcome scores included obesity, diabetes, poorer mental health, and a follow-up of less than 2 years.</p><p><strong>Conclusion: </strong> Patients treated with fasciocutaneous and muscle flaps experience comparable levels of functionality and quality of life after surgery. Flap selection should be based on defect characteristics, along with the surgeon's individual skills and preferences. A comprehensive approach that considers physical comorbidities, pain, and mental health is essential, as these factors significantly impact patient functionality and quality of life.</p>","PeriodicalId":16949,"journal":{"name":"Journal of reconstructive microsurgery","volume":" ","pages":""},"PeriodicalIF":2.2000,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of reconstructive microsurgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1055/a-2483-5388","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"SURGERY","Score":null,"Total":0}
引用次数: 0

Abstract

Background:  Free tissue transplantations are commonly used to treat complex lower extremity defects caused by trauma, vascular disease, or malignancy, particularly when vital structures are exposed. This study aimed to expand the knowledge on patient-reported outcomes by comparing fasciocutaneous and muscle flaps, with the goal of facilitating patient counseling. Additionally, patient-level risk factors associated with decreased functioning and health-related quality of life were identified.

Methods:  This retrospective, cross-sectional, multicenter study included patients who underwent microsurgical lower extremity reconstruction using free fasciocutaneous or muscle flaps between 2003 and 2021, with a minimum follow-up of 12 months. Data were collected from medical records, pain scores, Short-Form 36 (SF-36), and Lower Extremity Functional Scale (LEFS). Mean scores were compared between flap types and predictors of LEFS, SF-36 mental component summary (MCS), and SF-36 physical component summary (PCS) scores were determined using a backward stepwise regression model.

Results:  Of the 206 patients eligible, 100 (49%) were included in the retrospective part. A total of 89 (43%) responded to the questionnaires, with 62 treated using a fasciocutaneous flap and 27 with a muscle flap. No significant differences in total LEFS, SF-36 PCS, or MCS scores were found between the two flap type. Pain was a significant predictor of decreased functional outcomes for both flap types and was also linked to poorer mental health in patients treated with fasciocutaneous flaps. Other predictors of low patient-reported outcome scores included obesity, diabetes, poorer mental health, and a follow-up of less than 2 years.

Conclusion:  Patients treated with fasciocutaneous and muscle flaps experience comparable levels of functionality and quality of life after surgery. Flap selection should be based on defect characteristics, along with the surgeon's individual skills and preferences. A comprehensive approach that considers physical comorbidities, pain, and mental health is essential, as these factors significantly impact patient functionality and quality of life.

查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
下肢重建中的游离筋膜皮瓣与肌肉瓣:对功能和生活质量的影响。
游离组织移植常用于治疗由创伤、血管疾病或恶性肿瘤引起的复杂下肢缺损,尤其是当重要结构暴露在外时。本研究旨在通过比较筋膜皮瓣和肌肉瓣,扩大患者报告结果的知识面,从而促进患者咨询。此外,研究还发现了与功能下降和健康相关生活质量下降有关的患者风险因素。这项回顾性、横断面、多中心研究纳入了2003年至2021年间使用游离筋膜皮瓣或肌皮瓣接受显微外科下肢重建手术的患者,随访时间至少12个月。研究人员通过病历、疼痛评分、SF-36 短表(Short-Form 36)和下肢功能量表(Lower Extremity Functional Scale,LEFS)收集数据。通过逆向逐步回归模型,比较了不同皮瓣类型的平均得分,并确定了 LEFS、SF-36 心理成分总表(MCS)和 SF-36 身体成分总表(PCS)得分的预测因素。在符合条件的 206 名患者中,有 100 人(49%)被纳入回顾性部分。共有 89 名患者(43%)回答了调查问卷,其中 62 人使用筋膜皮瓣治疗,27 人使用肌肉瓣治疗。两种皮瓣类型的 LEFS 总分、SF-36 PCS 分值或 MCS 分值均无明显差异。在两种皮瓣类型中,疼痛都是导致功能性结果下降的重要预测因素,同时也与使用筋膜皮瓣治疗的患者精神健康状况较差有关。其他导致患者报告结果得分较低的因素包括肥胖、糖尿病、较差的心理健康状况以及随访时间少于两年。使用筋膜皮瓣和肌肉瓣治疗的患者术后的功能和生活质量水平相当。皮瓣的选择应基于缺损特征以及外科医生的个人技能和偏好。考虑身体合并症、疼痛和心理健康的综合方法至关重要,因为这些因素对患者的功能和生活质量有重大影响。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 去求助
来源期刊
CiteScore
4.50
自引率
28.60%
发文量
80
审稿时长
1 months
期刊介绍: The Journal of Reconstructive Microsurgery is a peer-reviewed, indexed journal that provides an international forum for the publication of articles focusing on reconstructive microsurgery and complex reconstructive surgery. The journal was originally established in 1984 for the microsurgical community to publish and share academic papers. The Journal of Reconstructive Microsurgery provides the latest in original research spanning basic laboratory, translational, and clinical investigations. Review papers cover current topics in complex reconstruction and microsurgery. In addition, special sections discuss new technologies, innovations, materials, and significant problem cases. The journal welcomes controversial topics, editorial comments, book reviews, and letters to the Editor, in order to complete the balanced spectrum of information available in the Journal of Reconstructive Microsurgery. All articles undergo stringent peer review by international experts in the specialty.
期刊最新文献
Free Fasciocutaneous versus Muscle Flaps in Lower Extremity Reconstruction: Implications for Functionality and Quality of Life. Utilizing Perforator Propeller Flaps for Donor Site Closure: Harvesting Large Workhorse Flaps without Lingering Concerns. Oncoplastic Surgery with Volume Replacement versus Mastectomy with Implant-Based Breast Reconstruction: Early Postoperative Complications in Patients with Breast Cancer. Effect of Enhanced Recovery After Surgery in Morbidly Obese Patients Undergoing Free Flap Breast Reconstruction. The Vascular Anatomy and Harvesting of the Lateral Femoral Condyle Flap in Pigs.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1