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Outcomes and Risk Factors in Microsurgical Forefoot Reconstruction.

Michael S Mayr-Riedler¹, Alexander Wacker¹, Florian Gedrich^1,2

¹Department for Plastic, Reconstructive, Hand and Burn Surgery, Munich Clinic, Bogenhausen, Germany.

Journal of Reconstructive Microsurgery

|September 8, 2022

Summary

This summary is machine-generated.

Microsurgical forefoot reconstruction outcomes depend on patient factors and surgical choices. Identifying risk factors like age and flap type aids in deciding between reconstruction and amputation, optimizing patient care.

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Area of Science:

Orthopedic Surgery
Microsurgery
Reconstructive Surgery

Background:

Forefoot defects often necessitate complex microsurgical reconstruction.
Reconstructive failure can yield outcomes worse than primary amputation.

Purpose of the Study:

To identify independent factors influencing surgical outcomes in forefoot reconstruction.
To determine factors affecting hospitalization duration post-reconstruction.

Main Methods:

Retrospective review of 93 free flap procedures in 87 patients (2008-2019).
Statistical analysis using binary logistic regression and correlation analysis.

Main Results:

Major complications occurred in 25.8% of cases; risk factors included age ≥60, fasciocutaneous flaps, arterial hypertension, and longer operative time.
Two venous anastomoses reduced major complication risk. Multiresistant bacterial colonization and larger defect size increased minor complication risk.
Median hospital stay was 28 days, with age significantly correlating with stay duration.

Conclusions:

Identified risk factors aid in personalized decisions for forefoot reconstruction versus primary amputation.
Performing two venous anastomoses and preferring muscle free flaps in high-risk patients may improve outcomes.