TY  - JOUR
A1  - Schmidt, Karsten
A1  - Jakubietz, Michael Gregor
A1  - Gilbert, Fabian
A1  - Hausknecht, Franca
A1  - Meffert, Rainer Heribert
A1  - Jakubietz, Rafael Gregor
T1  - Quality of life after flap reconstruction of the distal lower extremity: is there a difference between a pedicled suralis flap and a free anterior lateral thigh flap?
T2  - Plastic and Reconstructive Surgery - Global Open
N2  - Background: 
Flap reconstruction of the distal lower extremity is challenging. Especially, the concept of perforator surgery has increased available surgical options. Although results are generally judged in terms of objective facts, patients-perceived quality of life has largely remained unexamined. The aim of the study was to compare quality of life after lower extremity reconstruction with pedicled and free flaps.

Methods: 
Patients were evaluated retrospectively after reconstruction of defects of the distal lower extremity either with distally based adipofascial sural flap (pedicled reverse sural flap) or an anterior lateral thigh (ALT) flap. A specific questionnaire was developed to measure the patient’s quality of life, based on short form health survey-12, Dresden Body Image Score-35, Patient Health Questionnaire-4, and XSMFA questionnaires with additional specific questions. Furthermore, results, secondary surgeries, and complications were analyzed.

Results: 
Thirty-seven patients with reconstruction of lower limb defects treated with a pedicled reverse sural flap and 34 patients treated with an ALT flap were included in the study. There was no statistical significant difference in the overall satisfaction with the procedure in the long-term follow-up between both groups, but patients with ALT showed a higher satisfaction with the treatment in the initial postoperative period. Both groups demonstrated approximately similar results in the long term for self-acceptance and vitality.

Conclusions: 
Although anatomic situation may dictate flap choice coverage with free flaps, a less-complicated flap is by no means regarded as an inferior treatment option in patient’s estimation. Despite the intuitive speculation that patients with more advanced reconstruction methods should have better function and subsequently higher quality of life, this assumption was clearly not supported by data in this study.
KW  - reconstructive surgery
Y1  - 2019
UR  - https://opus.bibliothek.uni-wuerzburg.de/opus4-wuerzburg/frontdoor/index/index/docId/20394
UR  - https://nbn-resolving.org/urn:nbn:de:bvb:20-opus-203940
VL  - 7
IS  - 4
ER  -