Power-assisted suction lipectomy of fasciocutaneous flaps in the extremities.

Background: A bulky appearance is one of the major patient complaints after extremity reconstruction after fasciocutaneous flaps. Serial debulking procedures with staged excision are required to improve aesthetic and functional outcome, but these methods risk injury to the vascular pedicle and often require multiple procedures for adequate thinning of the flap. We suggest the use of power-assisted suction lipectomy for the debulking of fasciocutaneous flaps in the upper and lower extremities as a safe, effective, and efficient procedure.

Methods: From 2006 to 2009, we performed power-assisted suction lipectomy on the upper and lower extremities of 16 flaps in 15 patients who had previously undergone reconstruction with fasciocutaneous flaps after a traumatic injury.

Results: There was 100% flap survival without any complications. Only 2 of the 16 (12.5%) flaps required a secondary revision for further contouring.

Conclusions: In our experience power-assisted suction lipectomy is a safe and excellent adjunct in fasciocutaneous flap debulking and reduces the number of secondary revision procedures necessary. We recommend its use as an adjunct in debulking and contouring flaps used in extremity reconstruction.