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Is Donor-Site Pain following ALT Flap Harvest: Incidence, Prognostic Factors, and Is it Underreported?
Shayoni Nag, Edwin Ojiako, Rachel Smith, Julie West, Amy M. Moore
The Ohio State Wexner Medical Center Department of Plastic and Reconstructive Surgery
2024-12-16
Presenter: Shayoni Nag
Affidavit:
Amy. M Moore
Director Name: Amy M. Moore
Author Category: Other Specialty Resident
Presentation Category: Clinical
Abstract Category: Hand
Background
The anterolateral thigh (ALT) flap is recognized for minimal donor site morbidity, contributing significantly to postoperative quality of life. Despite this, donor site complications, such as pain and paresthesia, are underreported and infrequently studied due to small sample sizes. Previous systematic reviews have reported donor site pain incidences of 2.3% to 3.3%. This study investigated the incidence of donor site pain and paresthesia in patients undergoing ALT flap reconstruction at The Ohio State University Wexner Medical Center. We hypothesize that pain symptoms are underreported in physician documentation and literature.
Methods
A retrospective review included patients who underwent ALT flap harvest between January 2020 and May 2023. Patient demographics, surgical details, and postoperative outcomes were analyzed. Reports of donor site pain and paresthesia were compared between physician documentation and MyChart communications (e.g., nursing notes, phone communications, and messages) to assess underreporting.
Results
Fifty-eight patients (mean age: 50.6 years) were included. Donor site pain was documented in 36.2% of patients, while paresthesia occurred in 12.1%. An additional 10.3% of patients reported symptoms via MyChart. Rehabilitation was significantly associated with increased pain reports, while pain medication decreased them. Nerve injury during surgery did not significantly affect long-term pain reporting.
Conclusions
Donor site pain after ALT flap harvest is likely underreported, with this study identifying a higher incidence (36.2%) than prior reports. Future research should focus employing targeted questionnaires to capture the full extent of donor site complications, with the goal of enhancing patient quality of life.
