A donor-site preference utility study for three flaps used in lower extremity microvascular reconstruction

Area of Science:

• Plastic Surgery
• Reconstructive Surgery
• Patient-Reported Outcomes

Background:

• Fasciocutaneous free flaps are essential for lower extremity reconstruction.
• Donor-site scar location is a critical factor influencing patient choice.

Purpose of the Study:

• To compare patient preferences for donor-site scar location among three common fasciocutaneous free flaps.
• To evaluate patient ranking and rating of lateral arm, anterolateral thigh, and proximal lateral calf donor sites.

Main Methods:

• An internet-based survey presented a hypothetical lower extremity trauma scenario.
• Respondents ranked and rated three potential donor-site scar locations using a visual analog scale.
• 171 participants were included in the final analysis.

Main Results:

• The anterolateral thigh was the most preferred donor site (88.9% ranked first, 8.24/10 rating).
• The proximal lateral calf was ranked first by 8.7% (5.03/10 rating).
• The lateral arm was the least preferred site (2.3% ranked first, 2.18/10 rating).

Conclusions:

• Patient preference strongly favors the anterolateral thigh for donor-site scar concealment.
• Discussion between surgeon and patient regarding scar visibility versus topographical clustering is important.
• Anterolateral thigh flaps offer superior aesthetic outcomes based on patient preference.