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Coronoid-Temporalis Pedicled Flap for Orbital Floor Defect Reconstruction
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Free-Flap Reconstruction: What Do Microsurgeons Prefer for Themselves?

Benoit Chaput1, Ali Mojallal2, Nicolas Bertheuil3

  • 1Department of Plastic and Reconstructive Surgery, Rangueil University Hospital, Toulouse, France.

Journal of Reconstructive Microsurgery
|July 2, 2016
PubMed
Summary

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Microsurgeons increasingly prefer perforator flaps for reconstructive surgery due to lower donor site morbidity. This shift indicates a move towards advanced techniques like anterolateral thigh and thoracodorsal artery perforator flaps.

Area of Science:

  • Plastic Surgery
  • Microsurgery
  • Reconstructive Surgery

Background:

  • Perforator flaps have revolutionized reconstructive strategies for integumental defects.
  • Focus has shifted to minimizing donor site morbidity in microsurgery.
  • Investigating microsurgeons' personal flap choices reveals preferred donor sites.

Purpose of the Study:

  • To determine the preferred free flap for covering integumental defects among microsurgeons.
  • To identify the best free-flap donor sites based on expert opinion.
  • To compare the attitudes of junior and senior microsurgeons regarding flap selection.

Main Methods:

  • A survey, the "FreeFlap4U" study, involved 100 microsurgeons from French plastic surgery teams.
  • Participants indicated their preferred free flap for personal use.

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  • Microsurgeons were categorized as junior (<40 years) or senior (≥40 years) for comparative analysis.

    • Main Results:

    • Perforator flaps were the preferred choice for first-line treatment by junior microsurgeons and for second-line treatment by both junior and senior microsurgeons.
    • Junior microsurgeons prioritized lower donor site morbidity, while senior microsurgeons valued flap reliability.
    • Radial forearm and transverse rectus abdominis flaps were generally avoided due to high morbidity.

    Conclusions:

    • Microsurgeons show a clear preference for perforator flaps, including anterolateral thigh, thoracodorsal artery perforator, and superficial circumflex iliac artery perforator flaps.
    • This expert consensus suggests a future widespread adoption of these flaps for patient treatment.
    • The findings highlight a significant evolution in reconstructive surgery techniques and donor site considerations.