Development of an Online Risk Calculator Transforming Outcome Predictions in Secondary Free Flap Contouring
Background:. Soft tissue bulkiness following free flap transplantation may cause functional and aesthetic concerns, necessitating secondary flap contouring. This study summarized a decade of clinical experience, reported complication rates, identified risk factors, and established best practices. Me...
Saved in:
| Main Authors: | , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer
2025-07-01
|
| Series: | Plastic and Reconstructive Surgery, Global Open |
| Online Access: | http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000006947 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| Summary: | Background:. Soft tissue bulkiness following free flap transplantation may cause functional and aesthetic concerns, necessitating secondary flap contouring. This study summarized a decade of clinical experience, reported complication rates, identified risk factors, and established best practices.
Methods:. A retrospective analysis was conducted on 218 patients who underwent 338 secondary flap contouring procedures between 2012 and 2022 following free fasciocutaneous or myocutaneous flap transplantation. Patients were categorized based on contouring method: isolated tissue excision, liposuction, or a combination of both. Primary outcomes included wound dehiscence (WD) requiring reoperation and the need for repeated contouring. Risk factors were identified using univariable Poisson regressions, and a multivariate model was used to develop a risk calculator.
Results:. Among 218 patients, 196 (57.9%) underwent isolated tissue excision, 24 (7.1%) isolated liposuction, and 118 (34.9%) combined procedures. WD requiring reoperation occurred in 5.0% of patients, with no significant difference between techniques (P = 0.71). Risk factors for WD included larger flap size (P = 0.01), myocutaneous flaps (P = 0.001), and concurrent procedures (P = 0.04). Repeated contouring was less likely in older patients (P = 0.01), those with myocutaneous flaps (P = 0.001), and those undergoing combined techniques (P = 0.01).
Conclusions:. This study identified key factors influencing WD and the need for repeated contouring. Concurrent procedures were a modifiable risk factor for WD, whereas surgical technique affected the likelihood of repeated procedures. A web-based risk prediction tool was developed to improve surgical planning, providing personalized assessments to enhance outcomes and reduce complications. |
|---|---|
| ISSN: | 2169-7574 |