{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,25]],"date-time":"2025-09-25T16:54:12Z","timestamp":1758819252300,"version":"3.37.3"},"reference-count":16,"publisher":"Georg Thieme Verlag KG","issue":"01","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Reconstr Microsurg"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Background\u2003Free flaps are essential for limb salvage in patients with lower extremity (LE) trauma; however, significant donor-site morbidity could impact functional outcomes. This study compares postoperative ambulatory function between contralateral and ipsilateral free flap harvest in LE traumatic reconstruction.<\/jats:p><jats:p>\n          Methods\u2003A retrospective review was performed on patients who underwent LE reconstruction at a level 1 trauma center from 2009 to 2022. Flap characteristics, injury history, and ambulatory function were collected. Flap harvest laterality was determined in relation to the injured leg. The flaps were categorized as either fasciocutaneous or those that included a muscle component (muscle\/myocutaneous). Chi-squared and Mann\u2013Whitney tests were used for statistical analysis.<\/jats:p><jats:p>\n          Results\u2003Upon review, 173 LE free flaps were performed, of which 70 (65.4%) were harvested from the ipsilateral leg and 37 (34.6%) were from the contralateral leg. Among all LE free flaps, the limb salvage rate was 97.2%, and the flap survival rate was 94.4%. Full ambulation was achieved in 37 (52.9%) patients in the ipsilateral cohort and 18 (48.6%) in the contralateral cohort (p\u2009=\u20090.679). The average time to full ambulation did not vary between these cohorts (p\u2009=\u20090.071). However, upon subanalysis of the 61 muscle\/myocutaneous flaps, the ipsilateral cohort had prolonged time to full ambulation (6.4 months, interquartile range [IQR]: 4.8\u201313.5) compared with the contralateral one (2.3 months, IQR: 2.3 [1.0\u20133.9]) p\u2009=\u20090.007. There was no significant difference in time to full ambulation between flap harvest laterality cohorts among the fasciocutaneous flaps (p\u2009=\u20090.733).<\/jats:p><jats:p>\n          Conclusion\u2003Among free flaps harvested from the ipsilateral leg, fasciocutaneous flaps were associated with faster recovery to full ambulation relative to muscle\/myocutaneous flaps. Since harvesting muscle or myocutaneous flaps from the ipsilateral leg may be associated with a slower recovery of ambulation, surgeons may consider harvesting from a donor site on the contralateral leg if reconstruction requires a muscle component.<\/jats:p>","DOI":"10.1055\/s-0044-1787181","type":"journal-article","created":{"date-parts":[[2024,5,31]],"date-time":"2024-05-31T22:37:01Z","timestamp":1717195021000},"page":"053-062","source":"Crossref","is-referenced-by-count":2,"title":["Does Side Matter? The Impact of Free Flap Harvest Laterality on Ambulatory Function in Lower Extremity Traumatic Reconstruction"],"prefix":"10.1055","volume":"41","author":[{"given":"Tayla","family":"Moshal","sequence":"additional","affiliation":[{"name":"Keck School of Medicine, University of Southern California, Los Angeles, California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Idean","family":"Roohani","sequence":"additional","affiliation":[{"name":"Keck School of Medicine, University of Southern California, Los Angeles, California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0063-8584","authenticated-orcid":false,"given":"Eloise W.","family":"Stanton","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery, Keck School of Medicine, Los Angeles, California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paige K.","family":"Zachary","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery, Keck School of Medicine, Los Angeles, California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elizabeth","family":"Boudiab","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery, Keck School of Medicine, Los Angeles, California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jessica","family":"Lo","sequence":"additional","affiliation":[{"name":"Keck School of Medicine, University of Southern California, Los Angeles, California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emily","family":"Markarian","sequence":"additional","affiliation":[{"name":"Keck School of Medicine, University of Southern California, Los Angeles, California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joseph N.","family":"Carey","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery, Keck School of Medicine, Los Angeles, California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David A.","family":"Daar","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery, Keck School of Medicine, Los Angeles, California"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2024,5,31]]},"reference":[{"issue":"02","key":"ref1","doi-asserted-by":"crossref","first-page":"582","DOI":"10.1097\/PRS.0b013e3181c82ed1","article-title":"Lower limb salvage in trauma","volume":"125","author":"Y S Ong","year":"2010","journal-title":"Plast Reconstr Surg"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1097\/01.prs.0000305928.98611.87","article-title":"MOC-PS(SM) CME article: lower extremity reconstruction","volume":"121","author":"V Reddy","year":"2008","journal-title":"Plast Reconstr Surg"},{"issue":"S 03","key":"ref3","doi-asserted-by":"crossref","first-page":"S103","DOI":"10.1016\/j.injury.2008.06.004","article-title":"Microsurgery for lower extremity injuries","volume":"39","author":"A V Korompilias","year":"2008","journal-title":"Injury"},{"issue":"06","key":"ref4","doi-asserted-by":"crossref","first-page":"479","DOI":"10.1002\/jso.20485","article-title":"Lower extremity reconstruction","volume":"94","author":"L Heller","year":"2006","journal-title":"J Surg Oncol"},{"issue":"04","key":"ref5","doi-asserted-by":"crossref","first-page":"1029","DOI":"10.1097\/00006534-200109150-00036","article-title":"Lower extremity microsurgical reconstruction","volume":"108","author":"L Heller","year":"2001","journal-title":"Plast Reconstr Surg"},{"issue":"03","key":"ref6","doi-asserted-by":"crossref","first-page":"272","DOI":"10.1002\/1098-2388(200010\/11)19:3<272::AID-SSU9>3.0.CO;2-F","article-title":"Microvascular reconstruction of the lower extremity","volume":"19","author":"M R Zenn","year":"2000","journal-title":"Semin Surg Oncol"},{"issue":"S 01","key":"ref7","doi-asserted-by":"crossref","first-page":"228S","DOI":"10.1097\/PRS.0b013e3182008e12","article-title":"Role of microsurgery in lower extremity reconstruction","volume":"127","author":"H Engel","year":"2011","journal-title":"Plast Reconstr Surg"},{"issue":"S 05","key":"ref8","doi-asserted-by":"crossref","first-page":"S32","DOI":"10.1016\/j.injury.2019.10.045","article-title":"Selecting a free flap for soft tissue coverage in lower extremity reconstruction","volume":"50","author":"S D Kozusko","year":"2019","journal-title":"Injury"},{"issue":"02","key":"ref9","doi-asserted-by":"crossref","first-page":"926","DOI":"10.1097\/PRS.0b013e3182046a16","article-title":"An evidence-based approach to lower extremity acute trauma","volume":"127","author":"N D Medina","year":"2011","journal-title":"Plast Reconstr Surg"},{"issue":"01","key":"ref10","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1097\/PRS.0000000000003927","article-title":"Muscle versus fasciocutaneous free flaps in lower extremity traumatic reconstruction: a multicenter outcomes analysis","volume":"141","author":"E H Cho","year":"2018","journal-title":"Plast Reconstr Surg"},{"issue":"09","key":"ref11","doi-asserted-by":"crossref","first-page":"764","DOI":"10.1055\/s-0041-1726398","article-title":"The need to improve patient-centered outcome reporting following lower extremity flap reconstruction: a systematic review and meta-analysis","volume":"37","author":"K G Kim","year":"2021","journal-title":"J Reconstr Microsurg"},{"issue":"03","key":"ref12","doi-asserted-by":"crossref","first-page":"742","DOI":"10.1097\/PRS.0000000000007644","article-title":"Amputation versus free flap: long-term outcomes of microsurgical limb salvage and risk factors for amputation in the diabetic population","volume":"147","author":"V S Kotha","year":"2021","journal-title":"Plast Reconstr Surg"},{"issue":"02","key":"ref13","first-page":"S113","article-title":"Free flap reconstruction after lower limb trauma - outcome analysis using National Surgical Quality Improvement Programme (NSQIP) parameters","volume":"70","author":"M M Alam Atiq","year":"2020","journal-title":"J Pak Med Assoc"},{"issue":"04","key":"ref14","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1055\/s-0039-1701037","article-title":"Does laterality of lower extremity donor site affect outcomes in microvascular soft tissue lower extremity reconstruction?","volume":"36","author":"J W Yu","year":"2020","journal-title":"J Reconstr Microsurg"},{"issue":"05","key":"ref15","doi-asserted-by":"crossref","first-page":"384","DOI":"10.1055\/a-2181-7149","article-title":"Implications of single-vessel runoff on long-term outcomes of free tissue transfer for lower extremity reconstruction","volume":"40","author":"S S Huffman","year":"2024","journal-title":"J Reconstr Microsurg"},{"issue":"02","key":"ref16","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1016\/j.cps.2021.01.008","article-title":"Microsurgical reconstruction of the lower extremity in the elderly","volume":"48","author":"A Gohritz","year":"2021","journal-title":"Clin Plast Surg"}],"container-title":["Journal of Reconstructive Microsurgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/s-0044-1787181.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,12,24]],"date-time":"2024-12-24T23:39:58Z","timestamp":1735083598000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/s-0044-1787181"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,5,31]]},"references-count":16,"journal-issue":{"issue":"01","published-online":{"date-parts":[[2024,12,24]]},"published-print":{"date-parts":[[2025,1]]}},"URL":"https:\/\/doi.org\/10.1055\/s-0044-1787181","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0743-684X","1098-8947"],"issn-type":[{"type":"print","value":"0743-684X"},{"type":"electronic","value":"1098-8947"}],"subject":[],"published":{"date-parts":[[2024,5,31]]}}}