MORBIDITY OF DONOR AND RECIPIENT SITES AFTER FREE-FLAP SURGERY - A PROSPECTIVE-STUDY

Although free flap transfer is a routine procedure, we know of few stu dies about postoperative morbidity at recipient and donor sites. The s trength of the shoulder extension after harvesting of a Iatissimus dor si free flap (n = 12) and the patients' subjective opinions of morbidi ty at recipient and donor sites (n = 23) were assessed two and six wee ks, and three, six, and nine months after transfer of free muscle flap s. The patients' subjective opinions were measured on a scale from 1 ( normal) to 5 (very troublesome) and the strength of the shoulder was m easured in N. The flaps used were latissimus dorsi (n = 18), rectus ab dominis (n = 4), and gracilis (n = 1). All but one were transplanted t o a lower extremity. The extension strength of the shoulder decreased from 105 N to 70 N immediately after the operation (p < 0.05), and str ength did not improve during followup. Subjectively assessed morbidity at the recipient site and cosmetic disability decreased from troubles ome or very troublesome to moderate (p < 0.05). Swelling decreased fro m moderate at two weeks to normal or slight at nine months (p < 0.05). The subjective morbidity at the donor site decreased from slight at t wo weeks to normal at nine months for functional disability (p < 0.05) . Cosmetic: disability at the donor site was minimal during follow up. This study shows that shoulder extension strength deteriorated perman ently after part of the Iatissimus dorsi muscle had been removed even though subjective morbidity was minimal. Morbidity at the recipient si te decreased significantly with time. Subjective opinion of morbidity after latissimus dorsi transplantation did not differ from that after rectus abdominis transplantation.