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Patient Reported Outcomes after Local Flap Coverage for Complex Lower Extremity Trauma
Neel Bhagat, Scott N. Loewenstein, Kevin R. Knox, Joshua M. Adkinson, Aladdin H. Hassanein, Ravinder Bamba
IU School of Medicine-Department of Plastic Surgery
2021-01-31
Presenter: Neel D Bhagat
Affidavit:
I certify that the material proposed for presentation in this abstract has not been published in any scientific journal or previously presented at a major meeting. All work on this project represents the original work of the residents and medical students involved with this project.
Director Name: William A. Wooden
Author Category: Medical Student
Presentation Category: Clinical
Abstract Category: General Reconstruction
Background:
Complex lower extremity trauma can result in devastating outcomes including amputation and poor quality of life. Limb salvage can be achieved with the use of local muscle flaps (e.g. gastrocnemius, soleus flaps) or fasciocutaneous flaps (e.g. reverse sural and propeller flaps). Patient-reported outcome (PRO) studies have not been reported for local flaps. The purpose of this study is to compare PROs for lower extremity fasciocutaneous flaps and muscle flaps.
Methods:
All local flap coverage procedures for lower extremity trauma occurring between 2014-2019 were reviewed. 248 local flaps were performed for lower extremity salvage following trauma. PROs were recorded utilizing both the Lower Extremity Functional scale (LEFS) and 36-Item Short-Form Health Survey (SF-36).
Results:
37 patient surveys were collected (response rate 18.3%, mean follow-up time 3.2 years, average age 49.7 years). The average LEFS score was 42.1±14.2, the average physical functioning score was 43.0 ± 21.5. LEFS SF-36 physical functioning scores were significantly lower in patients who underwent muscle flaps compared to fasciocutaneous flaps (p=0.021 and p=0.022 respectively).
Conclusions:
Patients undergoing local flaps for lower extremity reconstruction have low quality of life scores. Patients who underwent local fasciocutaneous flap coverage for lower extremity trauma had higher post-operative LEFS and SF-36 physical functioning scores compared to those who underwent local muscle flaps. These data reflect the quality of life impact on patients who undergo local flap coverage of lower extremity trauma. With the goal of optimizing surgical management, reconstructive surgeons should continue to examine quality of life after limb salvage
