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DOI: 10.5999/aps.2019.00584
Sensory assessment of meshed skin grafts over free gracilis muscle flaps without nerve coaptation for lower extremity reconstruction
This study was supported by the Sino-Swiss Science and Technology Cooperation (Project No.: EG 07-032014), and the Swiss Society of Plastic, Reconstructive and Aesthetic Surgery.
Background Little is known about the sensate recovery of skin grafts over free non-neurotized muscle flaps. The aim of this study was to evaluate the sensitivity of free gracilis muscle flaps and meshed skin grafts without nerve coaptation.
Methods Thirteen consecutive patients with a median age of 55 years (range, 21–70 years) who underwent lower extremity reconstruction between September 2014 and October 2016 were included. Complications, flap contour, skin perception, and sensate recovery were assessed.
Results All flaps survived completely. In one patient, wound dehiscence and infection occurred 1 month after surgery. After a median follow-up of 14 months (range, 10–51 months), a satisfactory contour and skin perception were achieved. The Semmes-Weinstein (SW) monofilament test (154.8±22 g) and static two-point discrimination (2-PD) (12.6±0.7 mm) showed intermediate recovery compared to the surrounding site (41% and 76%, respectively). There was an intermediate correlation between flap size and sensate recovery (2-PD: r=0.27, P=0.36; SW test: r=0.45, P=0.12). Vibration sensation recovered to 60%, whereas thermal sensation remained poor (19% at 5°C and 25% at 25°C).
Conclusions Finer sensation could be partially restored. However, thermal sensation remained poor.
*The two authors contributed equally to this work.
This article was presented at the 53rd Annual Meeting of the Swiss Society of Plastic, Reconstructive and Aesthetic Surgery, on September 1–2, 2017, in St. Moritz, Switzerland.
The authors would like to thank Selina Ackermann (Department of Surgery, University Hospital Basel, Switzerland) for organizational work and revising our manuscript.
Publication History
Received: 19 April 2019
Accepted: 23 August 2019
Article published online:
07 March 2022
© 2021. The Korean Society of Plastic and Reconstructive Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonCommercial License, permitting unrestricted noncommercial use, distribution, and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes. (https://creativecommons.org/licenses/by-nc/4.0/)
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