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KMID : 1190620150110010011
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Journal of the Korean Wound Care Society
2015 Volume.11 No. 1 p.11 ~ p.15
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Clinical Study of Wound Healing after Flap Debulking or Secondary Procedure in Previous Free Flap Patients
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Ki Sae-Hwi
Choi Jong-Hwa
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Abstract
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In the presence of bulkiness or contour deformity of flaps, debulking procedures are essential for both aesthetic and functional improvement after free flap surgery for reconstructive procedures. Currently there is no definite standard regimen for debulking surgery. Our goal was to evaluate the safety interval between debulking operations, the dimension ratio of the debulking flap, and complications. With a single-institutional retrospective review of 13 debulking cases, the original free flap type, the interval between staged operations, dimension ratio of debulking flap, and complications were checked. There were 9 Anterolateral thigh (ALT) free flaps, 3 thoracodorsal artery perforator (TDAP) free flaps, and one superficial circumflex iliac artery perforator (SCIP) free flap. We performed single stage flap debulking in 4 cases and two stage flap debulking in 4 cases. The mean interval between flap surgery and first debulking procedure was 5.8 month (2∼13 month), the interval between first and second debulking was 5 month (2∼12 month). Mean dimension ratio of the first debulking surgery was 56.6% (40∼75%) and that of the second surgery was 48.7% (37.5∼70%). All flaps survived. Two cases had partial skin loss in the debulked flap, which were treated conservatively and with a skin graft. The minimum safe interval in our study was 2 months and the minimum dimension ratio for debulking surgery was 50%.
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KEYWORD
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Free flap, Debulking, Skin loss
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