LONG-TERM RESULTS AT THE DONOR SITE AFTER FREE MICROVASCULAR ILIAC CREST TRANSPLANTATION (EXPERIENCE IN 95 CASES) AND REVIEW OF THE LITERATURE

The use of anterior iliac crest as donor site for free osseous, osteom uscular and osteomyocutaneous flaps has developed during the past deca de into an important reconstructive instrument both in maxillofacial a nd in orthopedic surgery. Frequently published follow up studies focus on reconstructive success evaluation and modification of the operativ e technique. A long-term retrospective evaluation of the donor site af ter vascularized free anterior iliac crest transfer is presented. The study is based on 95 cases from 1985-93 including 11 cases from Switze rland (Kantonsspital Aarau). The patients were examined looking for ob jective complications and asked questions about their subjective sympt oms at the donor site. These objective and subjective results were the n correlated. Three percent developed hernias, loss of sensibility in the region of the lateral cutaneous femoral nerve occurred in 9.5%, bu t recovered in two-thirds. Seven percent of scars were unsatisfactory but no keloid or hypertrophic scars developed. All wounds healed prima rily. Minor alteration in contour of the donor site was notable in 20- 25% of the patients. Pain was a problem in an average of 7% of cases. Impairment in private life occurred in 3.5%, in professional life in 4 .7%, and in daily life in 11.9% of cases; 13.5% were dissatisfied with the situation of the donor site, while 12% of the interviewees were n ot satisfied with the preoperative information. Nonetheless, 98.8% of the patients were willing, if necessary, to undergo the same operation again.