The transverse myocutaneous gracilis (TMG) and the profunda artery perforator (PAP) flap are both safe choices for autologous breast reconstruction originating from the same donor region in the upper thigh. We aimed to compare the post-operative outcome regarding donor-site morbidity and quality of life. We included 18 patients who had undergone autologous breast reconstruction with a PAP flap (n = 27 flaps). Prospective evaluation of donor-site morbidity was performed by applying the same questionnaire that had already been established in a previous study evaluating TMG flap (n = 25 flaps) outcome, and results were compared. Comparison of the two patient groups showed equivalent results concerning patient-reported visibility of the donor-site scar and thigh symmetry. Still, the TMG group was significantly more satisfied with the scar ( = 0.015) and its position ( = 0.001). No difference was found regarding the ability to sit for prolonged periods. Donor-site wound complications were seen more frequently in the PAP group (29.6%) than in the TMG group (4.0%). Both groups expressed rather high satisfaction with their quality of life. Both flaps show minimal functional donor-site morbidity and high patient satisfaction. To minimize wound healing problems in PAP patients, thorough planning of the skin paddle is necessary.
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http://dx.doi.org/10.3390/curroncol29080448 | DOI Listing |
GMS Interdiscip Plast Reconstr Surg DGPW
December 2024
University Center for Orthopedics, Trauma and Plastic Surgery, Department of Plastic and Hand Surgery, University Hospital Carl Gustav Carus at the TU Dresden, Germany.
Background: Significant osseous defects or osteonecrosis, precipitated by open fractures, infections, or neoplastic conditions, represent infrequent yet critical medical conditions. The free vascularized fibular graft (FVFG) is a challenging but straightforward, reliable surgical intervention for the reconstruction of defects across various anatomical regions. This study aims to compare, quantify, and demonstrate the FVFG's versatility.
View Article and Find Full Text PDFPlast Reconstr Surg Glob Open
January 2025
From the Division of Plastic and Reconstructive Surgery, Washington University School of Medicine in Saint Louis, St. Louis, MO.
We present an approach for evaluating abdominal computed tomography (CT) scans that generates reproducible measures relevant to donor site morbidity after abdominally based breast reconstruction. Seventeen preoperative CT metrics were measured in 20 patients with software: interanterior superior iliac spine distance; abdominal wall protrusion; interrectus distance; rectus abdominis width, thickness, and width-to-thickness ratio; abdominal wall thickness; subcutaneous fat volume; visceral fat volume; right/left psoas volumes and densities; and right/left rectus abdominis volumes and densities. Two operators performed measures to determine interrater reliability (n = 10).
View Article and Find Full Text PDFOTO Open
January 2025
Department of Otolaryngology-Head and Neck Surgery, Winship Cancer Institute Emory University Atlanta Georgia USA.
Objective: Complex ablative maxillary and mandibular defects often require osseous free flap reconstruction. Workhorse options include the fibula, scapula, and osteocutaneous radial forearm flap (OCRFF). The choice of donor site for harvest should be driven not only by reconstructive goals but also by donor site morbidity.
View Article and Find Full Text PDFInt Wound J
January 2025
Department of Plastic and Reconstructive Surgery, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.
We aimed to compare the scar quality and recovery rate of joint activity for patients with joint-involved burn injuries receiving either artificial dermis (AD) with split-thickness skin graft (STSG) or full-thickness skin graft (FTSG) for reconstruction. The primary outcomes were %skin graft (SG) take. Secondary outcomes included complications such as the infection rate and donor site morbidity, 12-month scar quality evaluated using the Vancouver scar scale (VSS), recovery rate of joint activity and incidence of scar contracture requiring further revision.
View Article and Find Full Text PDFJ Plast Reconstr Aesthet Surg
February 2024
Plastic Surgery Department, St Thomas' Hospital, Guy's and St Thomas' NHS Foundation Trust, London, UK. Electronic address:
Background: Autologous breast reconstruction patients require thorough assessment, with the profunda femoris artery perforator (PAP) flap having become an important autologous reconstruction option alongside the deep inferior epigastric perforator (DIEP) flap. Breast reconstruction impacts patients psychologically, physically and mentally. The BREAST-Q aids in the assessment of patient-reported outcome measures (PROMs).
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