Perfusion Dynamics during Secondary Flap Debulking with Liposuction

Area of Science:

• Plastic Surgery
• Reconstructive Surgery
• Microsurgery

Background:

• Lower extremity reconstruction often requires flap transfer for soft tissue coverage.
• Achieving optimal contour and thin coverage necessitates secondary flap debulking.

Purpose of the Study:

• To compare conventional lipectomy with liposuction-assisted debulking for lower extremity flaps.
• To analyze perfusion dynamics and outcomes of liposuction debulking.

Main Methods:

• Comparative analysis of lipectomy versus liposuction debulking.
• Perioperative indocyanine green fluorescence angiography and laser Doppler imaging to assess flap perfusion.
• Evaluation of demographic data, surgical details, and postoperative complications.

Main Results:

• Similar complication rates between lipectomy (7.2% partial necrosis) and liposuction (7.8% partial necrosis) groups.
• Liposuction debulking with tumescent solution caused significant, temporary flap hypoperfusion (16.8% perfusion post-infiltration).
• Perfusion studies indicated misleading hypoperfusion that did not correlate with adverse outcomes.

Conclusions:

• Liposuction combined with peripheral excision is a safe and efficient single-stage method for flap debulking.
• Temporary perfusion reduction observed during liposuction debulking does not predict flap viability or complications.