Evaluating Donor Morbidity in ALT and TDAP Flaps With Drainless Closure Compared to Conventional Drain Placement

IF 1.5 3区医学 Q3 SURGERY

Microsurgery Pub Date : 2024-12-02 DOI:10.1002/micr.70003

Dianne Dong Un Lee, Kyeong-Tae Lee

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引用次数: 0

Abstract

Purpose

Recent trends in reconstructive surgery focus on rapid recovery, questioning the necessity of postoperative drains. Although harvesting perforator flaps causes minimal injury to anatomical structures at donor sites, attempts to omit drains have been limited. This study aimed to assess the safety of not using drains after harvesting the anterolateral thigh (ALT) perforators and the thoracodorsal artery perforator (TDAP) flaps.

Methods

All consecutive patients who underwent free ALT or TDAP flap-based reconstruction between 2020 and 2022 did not have drains placed at the donor site. Their donor morbidities were evaluated, and compared with those who underwent the same operation between 2016 and 2019 with donor drains placed.

Results

The drainless cohort consisting of 202 cases (159 ALT and 43 TDAP flaps) and the control cohort comprising 119 (52 ALT and 67 TDAP flaps) were analyzed. In ALT flap cases, the drainless cohort, apart from a larger flap dimension, exhibited comparable baseline characteristics to the control. The rates of overall donor complications were comparable between the two cohorts (10.1% vs. 11.5%, p = 0.795), as were rates for specific complications including wound dehiscence (p = 0.751) and seroma (p = 0.999). Multivariable analysis revealed no significant association between omitting drains and increased donor complications. Consistent results were obtained in the analysis for cases using TDAP flaps, with no significant difference between drainless and drain-using groups (p = 0.297).

Conclusions

Omitting drains in the donor site of ALT and TDAP flaps might be safe, not escalading the risks of donor morbidity.

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与常规引流放置相比，评估无引流关闭ALT和TDAP皮瓣供体发病率

目的近期重建手术的发展趋势关注于快速恢复，质疑术后引流的必要性。虽然收获穿支皮瓣对供体部位的解剖结构造成的伤害最小，但忽略引流管的尝试有限。本研究旨在评估在收获大腿前外侧穿支（ALT）和胸背动脉穿支（TDAP）皮瓣后不使用引流管的安全性。方法所有在2020 - 2022年间连续接受游离ALT或TDAP皮瓣重建的患者均未在供区放置引流管。对他们的供体发病率进行了评估，并与2016年至2019年期间接受相同手术并放置供体引流管的患者进行了比较。结果无引流组202例（159个ALT和43个TDAP瓣），对照组119例（52个ALT和67个TDAP瓣）。在ALT皮瓣病例中，无排水队列除了皮瓣尺寸更大外，表现出与对照组相当的基线特征。两组患者供体并发症发生率相当（10.1% vs. 11.5%, p = 0.795），特殊并发症包括伤口裂开（p = 0.751）和血肿（p = 0.999）。多变量分析显示漏排与供体并发症增加之间无显著关联。使用TDAP皮瓣的病例分析结果一致，无引流组和引流组之间无显著差异（p = 0.297）。结论省略ALT和TDAP皮瓣供区引流管可能是安全的，不会增加供区发病的风险。

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.