Abstract：
BACKGROUND: Of all body regions, lower extremity wounds have been and remain the greatest challenge. Free flaps have been accepted as a reasonable option to solve this dilemma, but they require the complexity of microsurgery. This study aimed to compare the postoperative and clinical outcomes of propeller flap and fasciocutaneous free flap in the reconstruction of complex lower limb defects.
METHODS: This randomized controlled trial was conducted from July 2021 to June 2023. Selected patients were randomized into two groups: the propeller flap group and fasciocutaneous free flap group. Demographic data, preoperative parameters, and postoperative parameter, including esthetic analysis, scar assessment, neurosensory analysis, psychosocial analysis, and lower extremity function, were estimated and statistically significant compared between the two study groups.
RESULTS: Road traffic accident (73.3%) was the most common etiology for lower limb defects in both groups. The foot and lower third of the leg were the most common site of defect, constituting 79.99%. The duration of surgery was significantly shorter in propeller flap as compared to fasciocutaneous free flaps. Flap size was smaller, with better neurosensory improvements in propeller flap group. Esthetic analysis, scar assessment, psychosocial analysis, and lower extremity functional analysis yielded similar results in both study groups.
CONCLUSIONS: Propeller flap has better outcomes compared to free flap in terms of smaller size of flap, shorter duration of surgery, and reduced length of hospital stay. Comparable results were obtained with respect to esthetic score, scar assessment score, psychosocial analysis, and neurosensory recovery and lower extremity functional score.
METHODS: This randomized controlled trial was conducted from July 2021 to June 2023. Selected patients were randomized into two groups: the propeller flap group and fasciocutaneous free flap group. Demographic data, preoperative parameters, and postoperative parameter, including esthetic analysis, scar assessment, neurosensory analysis, psychosocial analysis, and lower extremity function, were estimated and statistically significant compared between the two study groups.
RESULTS: Road traffic accident (73.3%) was the most common etiology for lower limb defects in both groups. The foot and lower third of the leg were the most common site of defect, constituting 79.99%. The duration of surgery was significantly shorter in propeller flap as compared to fasciocutaneous free flaps. Flap size was smaller, with better neurosensory improvements in propeller flap group. Esthetic analysis, scar assessment, psychosocial analysis, and lower extremity functional analysis yielded similar results in both study groups.
CONCLUSIONS: Propeller flap has better outcomes compared to free flap in terms of smaller size of flap, shorter duration of surgery, and reduced length of hospital stay. Comparable results were obtained with respect to esthetic score, scar assessment score, psychosocial analysis, and neurosensory recovery and lower extremity functional score.
摘要：
背景：在所有身体部位中，下肢伤口一直是并且仍然是最大的挑战。自由襟翼已被接受为解决这一困境的合理选择，但是它们需要显微外科手术的复杂性。本研究旨在比较螺旋桨皮瓣和筋膜皮瓣修复下肢复杂缺损的术后和临床效果。
方法：这项随机对照试验于2021年7月至2023年6月进行。将入选患者随机分为螺旋桨皮瓣组和筋膜皮瓣组。人口统计数据,术前参数,和术后参数，包括美学分析，疤痕评估,神经感觉分析,心理社会分析,和下肢功能，在两个研究组之间进行估计和统计学上的比较。
结果：道路交通事故（73.3％）是两组下肢缺损的最常见病因。足和腿下三分之一是最常见的缺损部位，占79.99%。与筋膜皮瓣相比，螺旋桨皮瓣的手术时间明显较短。襟翼尺寸较小，螺旋桨皮瓣组的神经感觉改善更好。美学分析，疤痕评估,心理社会分析,和下肢功能分析在两个研究组中产生了相似的结果.
结论：与游离皮瓣相比，螺旋桨皮瓣在皮瓣尺寸较小方面具有更好的效果，手术时间较短，缩短住院时间。在美学评分方面获得了可比的结果，疤痕评估评分，心理社会分析,神经感觉恢复和下肢功能评分。
方法：这项随机对照试验于2021年7月至2023年6月进行。将入选患者随机分为螺旋桨皮瓣组和筋膜皮瓣组。人口统计数据,术前参数,和术后参数，包括美学分析，疤痕评估,神经感觉分析,心理社会分析,和下肢功能，在两个研究组之间进行估计和统计学上的比较。
结果：道路交通事故（73.3％）是两组下肢缺损的最常见病因。足和腿下三分之一是最常见的缺损部位，占79.99%。与筋膜皮瓣相比，螺旋桨皮瓣的手术时间明显较短。襟翼尺寸较小，螺旋桨皮瓣组的神经感觉改善更好。美学分析，疤痕评估,心理社会分析,和下肢功能分析在两个研究组中产生了相似的结果.
结论：与游离皮瓣相比，螺旋桨皮瓣在皮瓣尺寸较小方面具有更好的效果，手术时间较短，缩短住院时间。在美学评分方面获得了可比的结果，疤痕评估评分，心理社会分析,神经感觉恢复和下肢功能评分。
