{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,7]],"date-time":"2026-02-07T19:52:45Z","timestamp":1770493965504,"version":"3.49.0"},"reference-count":36,"publisher":"Georg Thieme Verlag KG","issue":"06","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Reconstr Microsurg"],"published-print":{"date-parts":[[2024,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Background\u2003Lower extremity trauma often necessitates reconstruction with flap transfer. One of the reconstructive goals is a thin soft tissue coverage with appropriate contour. Therefore, a secondary debulking of the flap is usually performed.<\/jats:p><jats:p>\n          Methods\u2003Debulking through conventional lipectomy is compared with liposuction followed by excision of the defatted flap excess. Demographic data, surgical details, and postoperative outcomes are compared and analyzed. The perfusion dynamics of the flaps undergoing liposuction debulking are studied by means of perioperative indocyanine green fluorescence angiography, as well as postoperative laser Doppler imaging.<\/jats:p><jats:p>\n          Results\u2003Patients undergoing lipectomy (n\u2009=\u200969; 57.5%) or liposuction (n\u2009=\u200951; 42.5%) debulking had a similar rate of postoperative complications. Partial necrosis was observed in 7.2% (lipectomy) versus 7.8% (liposuction) of flaps. Fluorescence angiography showed a substantial decrease in flap perfusion following the infiltration with an epinephrine-containing tumescent solution (74.3%\u2009\u00b1\u20098.2% prior to infiltration versus 16.8%\u2009\u00b1\u20097.1% after infiltration; p\u2009&lt;\u20090.001), resulting in a dark flap appearance. Laser Doppler imaging confirmed the hypoperfusion on postoperative day 1.<\/jats:p><jats:p>\n          Conclusion\u2003Secondary debulking of a lower extremity flap can be safely and efficiently performed through liposuction combined with peripheral excision of the defatted flap in a single stage. Perfusion studies may show a misleading hypoperfusion of the defatted flap, which does not accurately predict subsequent necrosis or complications.<\/jats:p>","DOI":"10.1055\/s-0043-1777325","type":"journal-article","created":{"date-parts":[[2023,12,13]],"date-time":"2023-12-13T23:58:48Z","timestamp":1702511928000},"page":"423-434","source":"Crossref","is-referenced-by-count":7,"title":["Perfusion Dynamics during Secondary Flap Debulking with Liposuction"],"prefix":"10.1055","volume":"40","author":[{"given":"Maxim","family":"Geeroms","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Chang Gung Medical College and Chang Gung University, Taoyuan, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yun-Jui","family":"Lu","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Chang Gung Medical College and Chang Gung University, Taoyuan, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chung-Chen","family":"Hsu","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Chang Gung Medical College and Chang Gung University, Taoyuan, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ren-Wen","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Chang Gung Medical College and Chang Gung University, Taoyuan, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chih-Hung","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Chang Gung Medical College and Chang Gung University, Taoyuan, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cheng-Hung","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Chang Gung Medical College and Chang Gung University, Taoyuan, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2023,12,13]]},"reference":[{"issue":"04","key":"ref1","doi-asserted-by":"crossref","first-page":"1239","DOI":"10.1097\/PRS.0b013e31819e67c1","article-title":"Early experience with fluorescent angiography in free-tissue transfer reconstruction","volume":"123","author":"I A Pestana","year":"2009","journal-title":"Plast Reconstr Surg"},{"issue":"02","key":"ref2","doi-asserted-by":"crossref","first-page":"240","DOI":"10.1006\/mvre.1994.1018","article-title":"Infrared videoangiofluorography of the skin with indocyanine green\u2013rat random cutaneous flap model and results in 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