Bonetti Mario Alessandri, Jeong Tiffany, Liu Hilary Y, Arellano Jose Antonio, Pandya Sumaarg, Stofman Guy M, Egro Francesco M
From the Department of Plastic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA.
Ann Plast Surg. 2025 Jul 1;95(1):46-50. doi: 10.1097/SAP.0000000000004344. Epub 2025 Mar 17.
A paucity of studies investigates the outcomes of flap reconstruction in lower extremity acute burns. The aim of this study is to report outcomes of lower extremity acute burn requiring pedicled or free flap coverage.
A retrospective cohort study was conducted to compare the outcomes of patients undergone pedicled versus free flap reconstruction of acute lower extremity burns, between August 2010 and December 2022. Collected data included demographics, injury and flap characteristics, complications, and reoperations. χ 2 tests were used to measure differences in complication rates between pedicled and free flaps.
A total of 28 patients were involved in the study. Among them, 17 patients underwent 28 pedicled flap procedures, while 11 patients received a single free flap surgery each. In the free flap group, the overall complication rate was 54.5%. In the pedicled flap group, the overall complication rate was 25.0%. Free flaps showed a significantly higher rate of total flap loss compared to pedicled flaps (18.2% vs 0%, P = 0.021). Other differences were not statistically significant.
Flap coverage in lower extremity acute burns is rarely employed. Yet, in case of critical structures exposure it is often necessary. However, it is important to be aware of the high risk of complications, especially for more complex reconstructions requiring free tissue transfer.
关于下肢急性烧伤皮瓣重建结局的研究较少。本研究旨在报告需要带蒂或游离皮瓣覆盖的下肢急性烧伤的结局。
进行一项回顾性队列研究，比较2010年8月至2022年12月期间接受下肢急性烧伤带蒂与游离皮瓣重建患者的结局。收集的数据包括人口统计学资料、损伤和皮瓣特征、并发症及再次手术情况。采用χ²检验来衡量带蒂皮瓣与游离皮瓣并发症发生率的差异。
共有28例患者参与本研究。其中，17例患者接受了28次带蒂皮瓣手术，而11例患者各接受了1次游离皮瓣手术。在游离皮瓣组，总体并发症发生率为54.5%。在带蒂皮瓣组，总体并发症发生率为25.0%。与带蒂皮瓣相比，游离皮瓣的皮瓣完全丢失率显著更高（18.2%对0%，P = 0.021）。其他差异无统计学意义。
下肢急性烧伤很少采用皮瓣覆盖。然而，在关键结构暴露的情况下往往有必要进行皮瓣覆盖。但必须意识到并发症的高风险，尤其是对于需要游离组织移植的更复杂重建手术。
