Patient-reported esthetic outcomes following lower extremity free flap reconstruction: A cross-sectional multicenter study

Introduction: The goal of lower -extremity reconstructions is primarily to salvage the leg; however, esthetic outcomes are also important. This study aimed to assess the impact of a lower extremity free tissue transfer regarding social functioning, patient -reported esthetic outcomes, and possible differences between fasciocutaneous vs. muscle flaps. Material and Methods: For this cross -sectional multicenter study, patients operated between 2003 and 2021, with a minimum follow -up of 12 months, were identified. Outcomes were ob - tained from 89 patients. Patient -reported outcomes were assessed using a questionnaire con - taining 5 -point Likert scale questions grouped in three groups: aspect of the reconstructed leg, the aspect of the donor site, and the negative impact on social functioning. Physical functioning and mental health were assessed with the Short -Form -36. Results: The overall score for negative impact on social functioning was 22.2. This was 46.7 for the esthetic satisfaction of the reconstructed leg and 57.1 for the donor site. No significant differences were seen between patients who underwent a reconstruction with a fasciocutaneous flap com - pared to a muscle flap. Secondary surgical procedures for improving the esthetic aspect were performed in 12% of the patients in the fasciocutaneous group and 0% in the muscle group.