gms | German Medical Science

47. Jahrestagung der Deutschen Gesellschaft der Plastischen, Rekonstruktiven und Ästhetischen Chirurgen (DGPRÄC), 21. Jahrestagung der Vereinigung der Deutschen Ästhetisch-Plastischen Chirurgen (VDÄPC)

08.09. - 10.09.2016, Kassel

Postoperative negative pressure therapy significantly reduces flap complications in distally based peroneus brevis flaps: Experiences from 74 cases

Der Vakuumverband vermindert die Komplikationsrate beim distal gestielten Peronaeus brevis Lappen signifikant. Erfahrungen aus 74 Fällen

Meeting Abstract

Suche in Medline nach

  • presenting/speaker Holger Erne - Rechts der Isar TUM, Plastische Chirurgie, München, Deutschland
  • Daniel Schmauss - Rechts der Isar TUM, Plastische Chirurgie, München, Deutschland

Deutsche Gesellschaft der Plastischen, Rekonstruktiven und Ästhetischen Chirurgen. Vereinigung der Deutschen Ästhetisch-Plastischen Chirurgen. 47. Jahrestagung der Deutschen Gesellschaft der Plastischen, Rekonstruktiven und Ästhetischen Chirurgen (DGPRÄC), 21. Jahrestagung der Vereinigung der Deutschen Ästhetisch-Plastischen Chirurgen (VDÄPC). Kassel, 08.-10.09.2016. Düsseldorf: German Medical Science GMS Publishing House; 2016. Doc189

doi: 10.3205/16dgpraec189, urn:nbn:de:0183-16dgpraec1895

Veröffentlicht: 27. September 2016

© 2016 Erne et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe http://creativecommons.org/licenses/by/4.0/.


Gliederung

Text

Background: The distally based peroneus brevis muscle flap is a valuable therapeutic option for coverage of tissue defects around the ankle and the distal lower leg. However, the rate of postoperative flap complications requiring revisional surgery is high due to an impaired venous drainage and edema formation. The purpose of this study was to evaluate if postoperative negative pressure therapy is able to reduce flap complications.

Methods: From April 2010 until March 2014, we treated 74 patients with distally based peroneus brevis muscle flaps for defect coverage at the lower leg. In 4 cases, an osteomuscular composite flap has been used to treat partly stability-relevant bone defects. In 43 cases, negative pressure therapy (75mmHg, continuous) with a circular dressing was initiated after the flap procedure for 7 days. In 31 cases no negative pressure therapy was initiated. We retrospectively analysed those two groups of patients. The primary endpoint was the incidence of flap complications with a need for revision surgery, which were classified in three grades.

Results: The group treated with negative pressure therapy had significantly less flap complications when compared to the control group (p<0.0001). Concerning the single grades of complication, the negative pressure therapy-group had a significantly smaller rate of skin graft necrosis (grade 1; p = 0.014) and partial flap loss (grade 2; p = 0.002) compared to the control group. There were no statistically significant differences concerning complete flap loss (grade 3) between both groups.

Conclusion: Postoperative negative pressure therapy for 7 days reduces flap complications in distally based peroneus brevis flaps.