Risk factors of flap reduction after free flap

초록

Purpose: : Flap reduction after reconstruction with bulky flaps is often needed for cosmetic and functional improvement. Safe reduction requires proper timing and extent of tissue removal. This study aimed to determine appropriate intervals, reduction amounts, and risk factors for complications. Methods: We retrospectively reviewed 30 patients who underwent flap reduction following free tissue transfer between March 2014 and April 2023. Demographics, BMI, smoking history, interval between surgeries, extent of reduction, and postoperative complications were analyzed. Results: Among 30 patients (21 men, 9 women; mean age 45.9 years; mean BMI 25.5), 10 had a smoking history and hypertension was the most common comorbidity (n=9). The flap used for reconstruction were an anterolateral thigh free flap(n=17), thoracodorsal artery perforator free flap (n=6), latissimus dorsi free flap (n=5), gracilis musculocutaneous free flap (n=1), and internal pudendal artery with obturator artery perforator free flap (n=1). A total of 46 reduction procedures were performed, mostly involving skin and subcutaneous tissue excision. The mean reduction ratio was 46.9% and mean interval was 6.1 months. Complications occurred in 10 cases, with smoking identified as a significant risk factor. In 9 patients who underwen