000			03429nam a22003857a 4500
008			230316s20232023 xxu||||| |||| 00| 0 eng d
022			_a0738-1085
024			_a10.1002/micr.31008 [doi]
040			_aOvid MEDLINE(R)
650			_aIN PROCESS -- NOT YET INDEXED
099			_a36700658
245			_aA comparative analysis of fasciocutaneous versus muscle free flaps in peripheral vascular disease patients.
251			_aMicrosurgery. 2023 Jan 26
252			_aMicrosurgery. 2023 Jan 26
253			_aMicrosurgery
260			_c2023
260			_fFY2023
260			_p2023 Jan 26
265			_saheadofprint
265			_tPublisher
520			_aCONCLUSION: This study demonstrates that fasciocutaneous flaps had higher postoperative complication rates and more commonly required repeat arteriograms following LE FTT reconstruction due to recurrent ulcerations, suggesting greater utility of muscle flaps for FTT reconstruction in PVD patients. Copyright © 2023 Wiley Periodicals LLC.
520			_aMETHODS: Retrospectively reviewed PVD patients undergoing FTT between 2011 and 2021. Patients were stratified into fasciocutaneous and muscle free flap groups. Primary outcomes included complications, flap success, post-reconstruction vascular interventions, limb salvage, and ambulatory status.
520			_aOBJECTIVE: Chronic lower extremity (LE) wounds are common in patients with peripheral vascular disease (PVD). Free tissue transfer (FTT) provides healthy soft tissue for wound coverage and additional blood supply to promote wound healing. Given previous studies demonstrate increased complications in LE fasciocutaneous flaps, it was hypothesized that low vascular resistance in muscle flaps may be more advantageous for wound healing in PVD patients. Therefore, this study compared outcomes in PVD patients undergoing LE reconstruction with fasciocutaneous versus muscle free flaps.
520			_aRESULTS: One hundred thirteen patients with PVD were identified, of which 60.2% received fasciocutaneous (n = 68) and 39.8% received muscle flaps (n = 45). Forty-two patients (37.2%) underwent pre-flap endovascular interventions. Flap success rate was 98.2% (n = 111). Overall complication rate was 41.2% following fasciocutaneous flaps compared to 24.4% in muscle flaps (p = 0.067). Fasciocutaneous flaps had higher odds of ulceration requiring repeat angiogram within 1 year of reconstruction compared to muscle flaps (OR 3.4, 95% CI: 1.07-10.95, p = 0.047), and higher odds of requiring repeat angiogram overall (OR 3.4, 95% CI: 1.07-10.95, p = 0.047). No difference in requiring procedures in the operated limb within 1 year was observed (p = 0.155). At mean follow-up, there was no difference in limb salvage, ambulatory, and mortality rate between groups.
546			_aEnglish
651			_aMedStar Heart & Vascular Institute
656			_aMedStar General Surgery Residency
656			_aMedStar Georgetown University Hospital/MedStar Washington Hospital Center
657			_aJournal Article
700			_aAkbari, Cameron M _bMHVI
700			_aDeldar, Romina _bMGUH _cMedStar General Surgery Residency _dMD _eResident PGY 4
790			_aBovill JD _aSayyed AA _aHuffman SS _aDeldar R _aHaffner ZK _aTruong BN _aGupta N _aAttinger CE _aAkbari CM _aEvans KK
856			_uhttps://dx.doi.org/10.1002/micr.31008 _zhttps://dx.doi.org/10.1002/micr.31008
942			_cART _dJournal Article
999			_c11389 _d11389