Wound Healing Society

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Effect Of Acellular Dermal Matrix Apply After Anterolateral Thigh Flap Harvest.
Su-Yeon Bae, Chang-Hwan Ahn, Sun Je Kim, Sang-Ha Oh, Seung Han Song.
Chungnam National University Hospital, Daejeon, Korea, Republic of.

BACKGROUND The anterolateral thigh flap is one of the most useful flap in reconstruction, because of its reliability, large skin flap territory, and versatility1 In addition to this, the relatively small number of side effects is a common reason for this flap. The primary repair is usually done in donor site closure, but it takes a lot of tension and causes several donor site morbidity such as pain. We tried Acellular dermal matrix graft as a way to overcome this.METHODAmong the patients using the Anterolateral thigh free flap, 20 cases of donor fascia sutured with artificial dermis, and 21 cases of primary fascia suture were used for total 41 flaps. The postoperative ambulation recovery time, pain score, drainage removal, and wound problems of the donor site were investigated. RESULTS Of the 41 cases, there were no serious complications in the donor site including infection. Of 20 cases using the acellular dermal matrix, there was seroma and partial necrosis of skin and artificial dermis in each case. In one case, acellular dermal matrix was removed. However, the group using artificial dermis walked 4.9 days earlier than the control group and had a visual analogue scale at 5 days postoperatively of 1.8 points lower. ConclusionOur study suggested that, if we use it selectively, acellular dermal matrix may play an effective role in the donor site closure in anterolateral thigh flap. LEGEND
Table 1. Complication in acellular dermis graft group and primary closure group.
complicationPrimary closure (n=21)ADM graft (n=20)p value
Wound infection00
Wound dehiscence02 (10%)0.409
Seroma02 (10%)0.409
Herniation00

Table 2. Characteristics of Donor-Site fascia Closure Rates Using Two-Sample t Test
Primary closure (n=21)ADM graft (n=20)p value
Age59.4357.600.674
Skin defect width5.867.180.009*
Fascia defect width5.175.250.515
Hospital admission date33.9029.750.388
ICU admission date4.142.500.134
Drain removal date7.246.850.735
Foley cath removal date11.679.250.177
Postoperative gait date16.5211.650.038*
Visual analogue scale4.522.700.010*


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