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A retrospective cohort study comparing donor site morbidity between the L-shaped upper gracilis and transverse upper gracilis flap in breast reconstruction

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European Journal of Plastic Surgery Aims and scope Submit manuscript

Abstract

Background

Several modifications of the transverse upper gracilis (TUG) flap have been described to reduce donor site morbidity and augment flap volume in breast reconstruction. However, outcome comparisons are lacking in the literature. Our group previously described a design modification known as the L-shaped upper gracilis (LUG) flap.

Methods

This retrospective cohort study included patients treated with LUG and TUG flap breast reconstruction in a single centre between March 2019 and March 2023. The study compared donor site morbidity, flap volume and need for secondary procedures between the two cohorts.

Results

Thirty-one patients were included in each cohort (62 total). The patients presented similar demographics (age and BMI), as well as reconstruction modalities (immediate/delayed/stacked and unilateral/bilateral). Patients in the LUG cohort experienced faster donor site healing time and fewer donor site complications. The flap volume was similar in both cohorts, but fewer secondary procedures were required in patients treated with LUG reconstruction.

Conclusions

In our study, the LUG flap presented reduced donor site morbidity with less need for secondary procedures. Further studies are needed to validate these results on a larger scale and understand the psychosocial impact of a more conspicuous scar.

Level of evidence: Level III, therapeutic

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Funding

The authors declare that no funds, grants, or other support were received during the preparation of this manuscript.

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Authors and Affiliations

  1. Department of Plastic and Reconstructive Surgery, Queen Victoria Hospital, East Grinstead, UK

    Maria Chicco, Georgios Skepastianos & Adam Blackburn

Authors
  1. Maria Chicco
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  2. Georgios Skepastianos
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  3. Adam Blackburn
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Corresponding author

Correspondence to Maria Chicco.

Ethics declarations

Ethics approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. This study is a retrospective, observational cohort study and is therefore exempt from research ethics committee or Health Research Authority approval in keeping with national UK guidance.

Consent for publication

The data that support the findings of this study are available from the corresponding author, [MC], upon request.

Conflict of interests

The authors declare no competing interests.

Patient consent

This is a retrospective cohort study with pooled anonymised data from 60 patients. Patient consent is not required to share the anonymous outcome data. Patients’ consent was obtained for the use of the clinical photographs.

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Chicco, M., Skepastianos, G. & Blackburn, A. A retrospective cohort study comparing donor site morbidity between the L-shaped upper gracilis and transverse upper gracilis flap in breast reconstruction. Eur J Plast Surg 46, 1129–1133 (2023). https://doi.org/10.1007/s00238-023-02113-w

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  • DOI: https://doi.org/10.1007/s00238-023-02113-w

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