Abstract
The obesity epidemic continues to grow, and we have observed greater numbers of obese
individuals among patients seeking lower extremity reconstruction at our institution.
These patients may present a greater reconstructive challenge, thus we sought to identify
risk factors and differences in outcomes among patients undergoing lower extremity
reconstruction.
In this study we have performed a retrospective cohort analysis of patients undergoing
lower extremity reconstruction with free tissue transfer at our institution from 2005
to 2012. Patients were classified using the World Health Organization criteria for
obesity. Records were reviewed for patient characteristics, mechanism of injury, indications
for reconstruction, and surgical technique, with a focus on intraoperative and early
postoperative complications and outcomes.
A total of 43 out of the 119 patients undergoing lower extremity reconstruction were
obese (body mass index ≥ 30). Mechanism of injury, wound location, and the indications
for reconstruction were similar in both cohorts. No significant differences were found
in operative characteristics and techniques, including the type of flap utilized,
operative time, or thrombotic events. No significant differences were seen in complication
rates overall, however, obese patients more frequently needed second flaps (11.6 vs.
0%, p = 0.005).
This study concludes that successful lower extremity reconstruction can be performed
in the obese population, with few differences in complication rates and outcomes relative
to healthy weight patients.
Keywords
lower extremity reconstruction - free tissue transfer - obesity
