Donor Site Scar Preference in Patients Requiring Free Flap Reconstruction

In traumatic reconstruction, surgeons frequently harvest flaps from donor sites that they are comfortable performing and with favourable tissue characteristics without determining the patients preferred site. The study's goal was to determine participants free flap donor site preference based on aesthetics as it relates to the size of the defect being reconstructed.

Participants were asked to imagine that they were in a trauma that resulted in a wound of variable sizes. They were presented with a selection of common donor site scars produced from harvesting small, medium, and large free flaps. They were instructed to rank the donor sites in order of preference and score each donor site of 10.

Two hundred eighty-seven participants (mean age: 28, female: 62%) completed the survey. For small reconstructions, the preferred donor site scars were on the leg or back compared to arm or abdomen. For medium size reconstructions, scars on the back and upper thigh were preferred over scars on the abdomen and anterior thigh. In small and medium reconstructions, the midline abdominal scar scored significantly lower than other donor sites. Participants preferred donor sites on the back, the thigh, and lower abdomen for large reconstructions.

Participants preferred back, thigh, and hip locations perhaps relating to the ability to conceal these scars under clothing. If multiple flaps sites could be harvested, providing options to trauma patients undergoing free tissue transfer may result in increased satisfaction.