Aesthetic Microsurgical Reconstruction of Extremities

Yeo,  Hyeon Jung; Son,  Dae Gu; Kim,  Jun Hyung; Han,  Ki Hwan

doi:2011.20.1.1

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Arch Hand Microsurg > Volume 20(1); 2011 > Article

Case Report

Journal of the Korean Society for Surgery of the Hand 2011;20(1):1-7.
Published online May 31, 2011.
DOI: https://doi.org/10.12790/jkssh.2011.20.1.1

Aesthetic Microsurgical Reconstruction of Extremities

Hyeon-Jung Yeo, M.D., Dae-Gu Son, M.D., Jun-Hyung Kim, M.D., Ki-Hwan Han, M.D.

Department of Plastic and Reconstructive Surgery, Keimyung University School of Medicine, Daegu, Korea. handson@dsmc.or.kr

사지의 미용적 미세수술적 재건

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Abstract

  The aim of extremity reconstruction has focused on early wound coverage and functional recovery but rarely aesthetics. As the quality of life improves, however, the request for aesthetics has been growing.
  The authors has conducted retrospective reviews on the 86 cases that had extremity reconstruction using free flap, considering the characteristics of parts that had been assessed in primary operation between May 1996 and December 2010. Aesthetic grading was performed in four categories; color, texture, contour and marginal scar.
  Recipient sites were 42 hands, 19 feet, 14 lower extremities excluding feet and 10 upper extremities apart from the hand. Types of free flap were 16 latissimus dorsi free flaps, 13 anterolateral thigh free flaps, 12 dorsalis pedis free flaps, 8 transvers rectus abdominis free flaps, 7 gracillis free flaps, and 5 superficial temporal fascia free flaps. Total flap necrosis was seen in 8 cases(9.3%) and partial necrosis in 5 cases(5.8%). Secondary revision was done in 24 cases(27.9%) and the most common revision, debulking was done in 14 cases(16.3%).
  The authors has considered cosmetic aspects along with wound coverage and functional recovery in primary reconstruction. The results of aesthetic grading was 16.2 out of 20, and the secondary revision rate was reduced.

Key Words: Extremity reconstruction, Aesthetic reconstruction, Free flap

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