Division of Plastic Surgery, Kaohsiung Veterans General Hospital, Kaohsiung, R.O.C.
School of Medicine, National Yang Ming Chiao Tung University, Taipei, R.O.C.
J Int Med Res. 2023 Jul;51(7):3000605231180841. doi: 10.1177/03000605231180841.
Fasciocutaneous free flap based on the peroneal artery (boneless version) is an option in our practice for head and neck reconstruction. However, the associated donor-site morbidity has rarely been discussed. Thus, this study investigated the long-term patient-reported donor-site morbidity associated with peroneal flaps.
In this single-center, retrospective, observational study, 39 patients who underwent a free peroneal flap were enrolled. We evaluated donor-site morbidity with a modified questionnaire from Enneking et al. and Bodde et al.
Patient-reported daily life limitation was relatively low (5/39; 12.9%). Donor-site morbidities, namely pain (4/39; 10.3%), sensory disturbance (9/39; 23.1%), and walking limitation (9/39; 23.1%) were reported; most were rated minimal in severity. Among patients with walking limitation, muscle weakness (3/39; 7.7%), ankle instability (6/39; 15.4%), and gait alternation (6/39; 15.4%) were reported. Six patients developed claw toe.
Balancing successful reconstruction and donor-site morbidity is challenging. This long-term patient-reported survey revealed that harvesting peroneal flaps resulted in minimal or minor donor-site morbidity with no obvious impacts on the patients' daily quality of life. Although free radial forearm flaps and anterolateral thigh flaps are standard, free peroneal flaps have been proven reliable, with acceptable donor-site morbidity.
以腓动脉为蒂的游离皮瓣（无骨版）是我们进行头颈部重建的选择之一。然而，相关供区并发症很少被讨论。因此，本研究调查了与腓动脉皮瓣相关的长期患者报告的供区并发症。
在这项单中心、回顾性、观察性研究中，共纳入 39 例行游离腓动脉皮瓣的患者。我们使用 Enneking 等人和 Bodde 等人的改良问卷评估供区并发症。
患者报告的日常生活受限相对较低（5/39；12.9%）。报告的供区并发症包括疼痛（4/39；10.3%）、感觉障碍（9/39；23.1%）和行走受限（9/39；23.1%）；大多数为轻度。在行走受限的患者中，报告了肌肉无力（3/39；7.7%）、踝关节不稳定（6/39；15.4%）和步态改变（6/39；15.4%）。6 例患者发生爪形趾。
平衡成功的重建和供区并发症是具有挑战性的。这项长期的患者报告调查显示，采集腓动脉皮瓣导致轻微或轻度供区并发症，对患者的日常生活质量没有明显影响。虽然游离桡侧前臂皮瓣和前外侧股肌皮瓣是标准的，但游离腓动脉皮瓣已被证明是可靠的，供区并发症可接受。
