J reconstr Microsurg 2019; 35(03): 229-234
DOI: 10.1055/s-0038-1672126
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Reduced Anterolateral Thigh Flap Donor-Site Morbidity Using Incisional Negative Pressure Therapy

Gunther Mangelsdorff
1  Department of Plastic and Reconstructive Surgery, Hospital del Trabajador, Santiago, Chile
,
Pedro Cuevas
2  Department of Surgery, Hospital Clínico de la Universidad de Chile, Santiago, Chile
,
José Ramón Rodriguez
1  Department of Plastic and Reconstructive Surgery, Hospital del Trabajador, Santiago, Chile
,
Nicolás Pereira
1  Department of Plastic and Reconstructive Surgery, Hospital del Trabajador, Santiago, Chile
,
Enrica Ramirez
2  Department of Surgery, Hospital Clínico de la Universidad de Chile, Santiago, Chile
,
Ricardo Yañez
3  Department of Plastic and Reconstructive Surgery, Pontificia Universidad Católica de Chile, Santiago, Chile
› Author Affiliations
Further Information

Publication History

27 March 2018

09 August 2018

Publication Date:
27 September 2018 (eFirst)

Abstract

Background Primary closure of the donor-site after harvest of a large anterolateral thigh flap (ALT) is associated with significant morbidity. Incisional negative pressure therapy (INPT) may decrease complications in high-risk incisions. This study assessed if the incidence of complications after primary closure of the ALT flap donor-site decreases with INPT.

Methods Retrospective cohort study of a prospectively maintained database including patients who underwent upper and lower limb reconstruction, using an ALT free flap with primary closure of the donor-site. Two groups were defined: primary closure and INPT (study group) and primary closure with traditional dressings (control group). Nonparametric statistics were employed to identify prognostic factors, p < 0,05.

Results Fifty-eight free ALT flaps in 58 patients (study group n = 28; control group n = 30) were included. Median flap width and length were 9 cm (range: 5–14) and 25 cm (range: 10–48), respectively. Median follow-up was 19 months (range: 3–78 months). No significant differences in age or flap size were identified in both groups (p > 0.05). The global complication rate was 7.14% (n = 2) in the INPT group, and 37% (n = 11) in the control group (p = 0.007). The study group had a lower dehiscence and skin necrosis rate (p < 0.05). Multivariate logistic regression analysis showed IPNT was associated with a significant reduction of donor-site complications (p = 0.006), especially in patients with defects > 8 cm (p = 0.003).

Conclusion In this cohort study the use of INPT significantly reduced the donor-site morbidity after ALT flap harvest.