Use of liposuction for secondary revision of irradiated and nonirradiated free flaps Journal Article
| Authors: | Bui, D. T.; Mehrara, B. J.; Disa, J. J.; Cordeiro, P. G. |
| Article Title: | Use of liposuction for secondary revision of irradiated and nonirradiated free flaps |
| Abstract: | A number of patients with free tissue transfer require secondary revision to improve contour and regional definition to maximize function or appearance. However, there is controversy with regard to whether irradiated free flaps can be revised safely using liposuction. The purpose of this study was to compare the outcomes of revisionary procedures requiring liposuction in irradiated versus nonirradiated flaps. From December 1992 to July 2001, office and hospital records were reviewed retrospectively to identify patients who had undergone free tissue transfer and subsequent flap revision at a single institution. The number of revisions, amount of fat aspirated, timing of revision and the postoperative complications including infection, hematoma, wound dehiscence, and flap loss were reviewed. A total of 41 flap revisions using liposuction alone or with direct excision were performed on 33 free flaps (31 head and neck, 1 chest wall, and 1 extremity). The rectus musculocutaneous flap was the most commonly revised (88%). The average length of time to secondary revision of patients who had received postoperative radiotherapy to their flaps was significantly higher that those whose flaps had not been irradiated (P < 0.05). There were no postoperative complications except for 1 partial (20%) flap loss in a patient whose flap was irradiated. The difference in complication rates between the irradiated and nonirradiated group was not statistically significant. Secondary free flap revision using liposuction and direct excision is a safe technique for recontouring free flaps. There was no significant difference in complication rates for irradiated and nonirradiated flaps. Postoperative radiation therapy is therefore not a contraindication to secondary revision. However, these procedures should be delayed for several months after the acute effects of radiation have resolved. |
| Keywords: | adolescent; adult; child; clinical article; treatment outcome; aged; aged, 80 and over; child, preschool; middle aged; surgical technique; retrospective studies; review; surgical flaps; postoperative care; radiotherapy; retrospective study; postoperative complication; infant; head and neck neoplasms; irradiation; outcomes research; postoperative infection; graft rejection; free tissue graft; myocutaneous flap; hematoma; wound dehiscence; liposuction; lipectomy; humans; human; male; female; priority journal; rectus musculocutaneous flap |
| Journal Title: | Annals of Plastic Surgery |
| Volume: | 52 |
| Issue: | 6 |
| ISSN: | 0148-7043 |
| Publisher: | Lippincott Williams & Wilkins |
| Date Published: | 2004-06-01 |
| Start Page: | 541 |
| End Page: | 545 |
| Language: | English |
| DOI: | 10.1097/01.sap.0000123352.01368.e0 |
| PROVIDER: | scopus |
| PUBMED: | 15166973 |
| DOI/URL: | |
| Notes: | Ann. Plast. Surg. -- Cited By (since 1996):3 -- Export Date: 16 June 2014 -- CODEN: APCSD -- Source: Scopus |
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