Reduced Anterolateral Thigh Flap Donor-Site Morbidity Using Incisional Negative Pressure Therapy

Background  Primary closure of the donor-site after harvest of a large anterolateral thigh flap (ALT) is associated with significant morbidity. Incisional negative pressure therapy (INPT) may decrease complications in high-risk incisions. This study assessed if the incidence of complications after primary closure of the ALT flap donor-site decreases with INPT. Methods  Retrospective cohort study of a prospectively maintained database including patients who underwent upper and lower limb reconstruction, using an ALT free flap with primary closure of the donor-site. Two groups were defined: primary closure and INPT (study group) and primary closure with traditional dressings (control group). Nonparametric statistics were employed to identify prognostic factors, p Results  Fifty-eight free ALT flaps in 58 patients (study group n  = 28; control group n  = 30) were included. Median flap width and length were 9 cm (range: 5–14) and 25 cm (range: 10–48), respectively. Median follow-up was 19 months (range: 3–78 months). No significant differences in age or flap size were identified in both groups (p > 0.05). The global complication rate was 7.14% ( n  = 2) in the INPT group, and 37% ( n  = 11) in the control group ( p  = 0.007). The study group had a lower dehiscence and skin necrosis rate ( p p  = 0.006), especially in patients with defects > 8 cm ( p  = 0.003). Conclusions  In this cohort study the use of INPT significantly reduced the donor-site morbidity after ALT flap harvest.