The Effect of Leg Dominance in Patients on Perforator-Based Flaps Elevated From the Lower Extremities

IF 1.5 3区医学 Q3 SURGERY

Microsurgery Pub Date : 2024-10-22 DOI:10.1002/micr.31251

Dicle Aksöyler, Yiğit Yalçin, Görkem Durak, Mehmet Semih Çakir, Luigi Losco, Erol Kozanoğlu

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Abstract

Background

The lower extremities are the largest donor sites in the body for perforator flap reconstruction. Multislice row computed tomography angiography allows for a multiplanar assessment of perforators using a large number of three-dimensional images with high resolution. In this study, the effect of leg dominance on perforator flap donor site preference was investigated radiologically to increase preoperative perforator mapping precision and surgical success.

Patients and Methods

The study included 40 patients. Superior gluteal artery perforator (SGAP) flap, inferior gluteal artery perforator (IGAP) flap, superficial circumflex iliac artery perforator flap, anterolateral thigh (ALT) flap, profunda artery perforator (PAP) flap, medial sural artery perforator (MSAP) flap, peroneal artery perforator (PP) flap, and posterior tibial artery perforator (PTAP) flap were analyzed according to their number of perforators (> 0.8-mm perforators counted, number of larger perforators [nLP]), dominant perforator diameter (DPD), related muscle thickness (RMT), and related subcutaneous tissue thickness (RSTT) in each leg.

Results

Of these 40 patients, 35 (87.5%) were right-leg dominant and 5 (12.5%) were left-leg dominant. The dominant leg had higher DPD for MSAP, PTAP, and PP than the nondominant leg (p = 0.08, p = 0.06, and p = 0.06, respectively). The dominant leg had a significantly higher nLP (> 0.8 mm) in MSAP, PTAP, and PP flaps than the nondominant leg (p < 0.05). Except for the PAP flap (adductor magnus muscle; p > 0.05), RMT of all other perforator flaps (SGAP, IGAP, ALT, MSAP, PTAP, and PP) was statistically higher in the dominant leg (p < 0.05). There was no statistically significant difference in RSTT between any of the two groups (p > 0.05).

Conclusion

According to findings, the dominant leg could be considered a donor site preference to improve surgical outcomes and reduce microsurgical complications due to an increased nLP, perforator diameter, and RMT.

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患者腿部优势对从下肢抬高的穿孔器皮瓣的影响

背景：下肢是全身最大的穿孔皮瓣重建供体部位。多层行计算机断层扫描血管造影术可利用大量高分辨率的三维图像对穿孔器进行多平面评估。本研究通过放射学方法研究了腿部优势对穿孔器皮瓣供区选择的影响，以提高术前穿孔器绘图的精确度和手术成功率：研究包括40名患者。根据穿孔数量（> 0.8毫米的穿孔计数，较大穿孔的数量[nLP]）、每条腿的主要穿孔直径（DPD）、相关肌肉厚度（RMT）和相关皮下组织厚度（RSTT）：在这 40 名患者中，35 人（87.5%）为右腿优势型，5 人（12.5%）为左腿优势型。优势腿的 MSAP、PTAP 和 PP 的 DPD 均高于非优势腿（分别为 p = 0.08、p = 0.06 和 p = 0.06）。优势腿的MSAP、PTAP和PP皮瓣的nLP（> 0.8 mm）明显高于非优势腿（p 0.05），优势腿所有其他穿孔器皮瓣（SGAP、IGAP、ALT、MSAP、PTAP和PP）的RMT均高于非优势腿（p 0.05）：根据研究结果，优势腿可作为首选供体部位，以提高手术效果并减少显微外科并发症，因为优势腿的nLP、穿孔器直径和RMT均有所增加。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Microsurgery 医学-外科

CiteScore

3.80

自引率

19.00%

发文量

128

审稿时长

4-8 weeks

期刊介绍： Microsurgery is an international and interdisciplinary publication of original contributions concerning surgery under microscopic magnification. Microsurgery publishes clinical studies, research papers, invited articles, relevant reviews, and other scholarly works from all related fields including orthopaedic surgery, otolaryngology, pediatric surgery, plastic surgery, urology, and vascular surgery.