Effect on scar in donor area of small-and medium-sized anterolateral thigh perforator flap harvested from superficial and deep layer of the superficial fascia / 中华显微外科杂志

ABSTRACT

Objective:To compare the effect on scar in donor area of small-and medium-sized anterolateral thigh perforator flap(ALTPF) harvested from superficial and deep layer of the superficial fascia.Methods:A retrospective analysis was performed on 31 patients who had small-and medium-sized soft tissue defects in the extremities and admitted to the Department of Burns and Plastic Surgery of the Affiliated Hospital of Zunyi Medical University from January 2020 to February 2021. All the patients were repaired with ALTPFs. The sizes of defect ranged from 5.0 cm×3.5 cm to 17.0 cm×6.0 cm, and the flaps sized from 6.0 cm×4.0 cm to 20.0 cm×6.0 cm. Fifteen ALTPFs were harvested from superficial layer of superficial fascia (modified group), and 16 harvested from deep layer of superficial fascia (traditional group). The flap donor sites were sutured directly using the "Zunyi suture method". Appearance of scars was assessed within the Vancouver Scar Scale (VSS) and in addition the width of scars was been recorded. The data of the 2 groups were statistically analyzed. There was statistically significant difference when P<0.05. Results:All flaps were successfully viable. All wounds healed in Ⅰ stage and donor incisions healed in Ⅰ stage at 2-3 weeks after the surgery. All patients entered postoperative follow-up for 6 to 26 months, with a mean of 10.7 months. There was no ischaemic necrosis at the donor margin. There was no significant difference between circumference of thighs between the modified group and traditional group [ (0.10±0.40) cm and (0.03±0.39) cm, respectively]( P>0.05). VSS were found lower in the modified group (2.00±1.46) than that in the traditional group (3.06±1.61)( t=2.132, P=0.039), as well as the scars were found smaller at the widest point[(6.67±3.85) cm and(16.06±6.63) cm, respectively. t=2.807, P=0.005]. The differences were statistically significant( P<0.05). Conclusion:Small-and medium-sized ALTPFs, harvested in the superficial layer of superficial fascia, can reduce the width of the donor scar, improve the surgical outcome and increase patient satisfaction.