From Esthetic Medicine to Optimizing Reconstructive Outcome: A Feasibility Trial on Secondary Refinement of Fasciocutaneous Anterolateral Thigh Flaps with Cryolipolysis.


Journal

Journal of reconstructive microsurgery
ISSN: 1098-8947
Titre abrégé: J Reconstr Microsurg
Pays: United States
ID NLM: 8502670

Informations de publication

Date de publication:
Feb 2023
Historique:
pubmed: 24 9 2022
medline: 25 1 2023
entrez: 23 9 2022
Statut: ppublish

Résumé

 Free adipocutaneous anterolateral thigh (ALT) flaps have evolved as workhorse flaps to reconstruct complex, multicompound defects. While coverage is safely achieved, flaps may remain bulky. As a standard of care, flaps are refined with liposuction, partial excision, or combination of both. Cryolipolysis is widely used for fat reduction in esthetic medicine. This pilot comparative study analyses whether cryolipolysis may serve as a safe alternative method to effectively reduce volume in fasciocutaneous flaps. Moreover, patients' satisfaction with the procedure is evaluated.  In this single-center, retrospective, interventional comparative cohort study, 10 patients with free subfascial ALT flaps for distal extremity reconstruction underwent cryolipolysis (60 minutes, -9°C). Circumference of the extremities and subcutaneous fat thickness were determined before (T1) and 12 weeks (T2) after cryolipolysis. Patient satisfaction was evaluated with a questionnaire of Likert's scale questions. Duration of hospital stay, intervention time, costs, and possible complications were analyzed and compared with surgical flap contouring (  All patients undergoing cryolipolysis were male, with a median age of 52 years without arterial disease-like state or deep vein thrombosis (DVT). At T2, a significant reduction of circumference of 1.8 ± 0.9 cm (  This is a novel application of evolving body-contouring cryolipolysis from esthetic medicine into optimizing outcomes in reconstructive surgery. Cryolipolysis has been shown to be relatively safe and effective to reduce ALT's volume with high patients' satisfaction. This successful pilot study encourages further investigation with a prospective randomized control trial.

Sections du résumé

BACKGROUND BACKGROUND
 Free adipocutaneous anterolateral thigh (ALT) flaps have evolved as workhorse flaps to reconstruct complex, multicompound defects. While coverage is safely achieved, flaps may remain bulky. As a standard of care, flaps are refined with liposuction, partial excision, or combination of both. Cryolipolysis is widely used for fat reduction in esthetic medicine. This pilot comparative study analyses whether cryolipolysis may serve as a safe alternative method to effectively reduce volume in fasciocutaneous flaps. Moreover, patients' satisfaction with the procedure is evaluated.
METHODS METHODS
 In this single-center, retrospective, interventional comparative cohort study, 10 patients with free subfascial ALT flaps for distal extremity reconstruction underwent cryolipolysis (60 minutes, -9°C). Circumference of the extremities and subcutaneous fat thickness were determined before (T1) and 12 weeks (T2) after cryolipolysis. Patient satisfaction was evaluated with a questionnaire of Likert's scale questions. Duration of hospital stay, intervention time, costs, and possible complications were analyzed and compared with surgical flap contouring (
RESULTS RESULTS
 All patients undergoing cryolipolysis were male, with a median age of 52 years without arterial disease-like state or deep vein thrombosis (DVT). At T2, a significant reduction of circumference of 1.8 ± 0.9 cm (
CONCLUSION CONCLUSIONS
 This is a novel application of evolving body-contouring cryolipolysis from esthetic medicine into optimizing outcomes in reconstructive surgery. Cryolipolysis has been shown to be relatively safe and effective to reduce ALT's volume with high patients' satisfaction. This successful pilot study encourages further investigation with a prospective randomized control trial.

Identifiants

pubmed: 36150694
doi: 10.1055/s-0042-1755259
doi:

Types de publication

Clinical Trial Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

156-164

Informations de copyright

Thieme. All rights reserved.

Déclaration de conflit d'intérêts

Disclosure The authors report no conflicts of interest in this work.

Auteurs

Sarah S Nagel (SS)

Department of Hand, Plastic and Reconstructive Surgery, Microsurgery, Burn Center, BG Klinik Ludwigshafen, Plastic and Hand Surgery, University of Heidelberg, Germany.

Annika Rauh (A)

Department of Hand, Plastic and Reconstructive Surgery, Microsurgery, Burn Center, BG Klinik Ludwigshafen, Plastic and Hand Surgery, University of Heidelberg, Germany.

Laura C Siegwart (LC)

Department of Hand, Plastic and Reconstructive Surgery, Microsurgery, Burn Center, BG Klinik Ludwigshafen, Plastic and Hand Surgery, University of Heidelberg, Germany.

Gabriel Hundeshagen (G)

Department of Hand, Plastic and Reconstructive Surgery, Microsurgery, Burn Center, BG Klinik Ludwigshafen, Plastic and Hand Surgery, University of Heidelberg, Germany.

Dimitra Kotsougiani-Fischer (D)

Department of Hand, Plastic and Reconstructive Surgery, Microsurgery, Burn Center, BG Klinik Ludwigshafen, Plastic and Hand Surgery, University of Heidelberg, Germany.

Simon Kuepper (S)

Department of Plastic Surgery and Burn Center, BG Hospital Berlin, Germany.

Ulrich Kneser (U)

Department of Hand, Plastic and Reconstructive Surgery, Microsurgery, Burn Center, BG Klinik Ludwigshafen, Plastic and Hand Surgery, University of Heidelberg, Germany.

Christoph Hirche (C)

Department of Hand, Plastic and Reconstructive Surgery, Microsurgery, Burn Center, BG Klinik Ludwigshafen, Plastic and Hand Surgery, University of Heidelberg, Germany.
Department of Plastic, Hand and Reconstructive Microsurgery, Hand-Trauma and Replantation Center, BG Unfallklinik Frankfurt am Main GmbH, Goethe University of Frankfurt, Germany.

Articles similaires

[Redispensing of expensive oral anticancer medicines: a practical application].

Lisanne N van Merendonk, Kübra Akgöl, Bastiaan Nuijen
1.00
Humans Antineoplastic Agents Administration, Oral Drug Costs Counterfeit Drugs

Smoking Cessation and Incident Cardiovascular Disease.

Jun Hwan Cho, Seung Yong Shin, Hoseob Kim et al.
1.00
Humans Male Smoking Cessation Cardiovascular Diseases Female
Humans United States Aged Cross-Sectional Studies Medicare Part C
1.00
Humans Yoga Low Back Pain Female Male

Classifications MeSH