Yeung Laurence C, Ellstrom Christopher L, Martin Mark C
Department of Plastic Surgery, Loma Linda University Medical Center, Loma Linda, CA, USA.
Ann Plast Surg. 2011 Jan;66(1):59-61. doi: 10.1097/SAP.0b013e3181d6e2b9.
Fasciocutaneous free flaps are commonly used in reconstruction of the lower extremity. The purpose of this study was to compare preferences in donor-site scar location among 3 flaps capable of covering a wound that is 4 to 6 cm wide with primary closure of the donor-site. The locations chosen were the lateral arm, the anterolateral thigh, and the proximal lateral calf. Survey participants were presented a hypothetical scenario of a trauma patient with an open anterior tibial wound, requiring free flap reconstruction. In an internet-based survey, respondents were asked to take on the role of the patient and to rate the 3 donor-site scar locations with a visual analog scale and rank them in order of preference. One hundred ninety-eight respondents (mean age 24.7 ± 2.9 years, 49.1% men) responded to the survey, and 171 were included. The anterolateral thigh was the most preferred donor site (88.9% ranked first, rated 8.24 ± 1.86), followed by the proximal lateral calf (8.7% ranked first, rated 5.03 ± 1.96), and the lateral arm was last (2.3% ranked first, rated 2.18 ± 1.62). Survey participants clearly preferred the anterolateral thigh as a donor site. This preference may be related to the ability to conceal the scar under clothing, whereas the proximal lateral calf could keep scars in a smaller topographical area of the body. When other aspects of the reconstruction are equal, it may be important for the surgeon and patient to discuss the goals of concealing the donor-site scar versus keeping the wound and reconstruction-related scars in a smaller topographical area of the body.
筋膜皮瓣游离移植常用于下肢重建。本研究旨在比较3种能够覆盖4至6厘米宽伤口且供区可一期缝合的皮瓣在供区瘢痕位置方面的受青睐程度。所选位置为上臂外侧、大腿前外侧和小腿近端外侧。调查参与者面对一个假设情景：一名创伤患者胫骨前部开放性伤口，需要游离皮瓣重建。在一项基于互联网的调查中，要求受访者扮演患者角色，用视觉模拟量表对3个供区瘢痕位置进行评分，并按偏好程度排序。198名受访者（平均年龄24.7±2.9岁，男性占49.1%）回复了调查，171人被纳入。大腿前外侧是最受青睐的供区（88.9%排名第一，评分为8.24±1.86），其次是小腿近端外侧（8.7%排名第一，评分为5.03±1.96），上臂外侧排在最后（2.3%排名第一，评分为2.18±1.62）。调查参与者明显更倾向于选择大腿前外侧作为供区。这种偏好可能与将瘢痕隐藏在衣物下的能力有关，而小腿近端外侧可使瘢痕位于身体较小的局部区域。当重建的其他方面相同时，外科医生和患者讨论隐藏供区瘢痕与将伤口及重建相关瘢痕置于身体较小局部区域的目标可能很重要。
