{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T10:08:39Z","timestamp":1780308519325,"version":"3.54.0"},"reference-count":31,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,5,30]],"date-time":"2026-05-30T00:00:00Z","timestamp":1780099200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Plast Surg (Oakv)"],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Increased limb salvage rates necessitate greater attention to flap durability during subsequent staged or revisional orthopedic procedures in the lower extremity. Direct evidence comparing outcomes in this specific context is limited, thus we compared the performance of muscle flaps (MF) and fasciocutaneous flaps (FCF) and sought to identify predictors of complications following flap re-elevation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Adults (&gt;18 years) with lower extremity injuries (knee and below) who underwent flap reconstruction and subsequent flap re-elevation for a secondary orthopedic procedure between years 2000 and 2020 were reviewed. Patient factors, operative details, and postoperative trajectory were documented. Complications following a secondary orthopedic procedure were classified as minor or major (Clavien-Dindo \u2265 III). Categorical data were assessed for independence with Fisher Exact test and continuous variables with Mann\u2013Whitney\n                      <jats:italic toggle=\"yes\">U<\/jats:italic>\n                      test.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 64 patients included (MF\u2009=\u200952, FCF\u2009=\u200912), 14.1% experienced a major complication with similar rates between FCFs (\n                      <jats:italic toggle=\"yes\">n\u2009=<\/jats:italic>\n                      \u20092, 16.7%) and MFs (\n                      <jats:italic toggle=\"yes\">n\u2009=<\/jats:italic>\n                      \u20097, 13.5%). However, the occurrence of a primary complication (OR = 7.82, CI [1.47\u201341.66]) and an unplanned secondary orthopedic procedure (\n                      <jats:italic toggle=\"yes\">n\u2009=<\/jats:italic>\n                      \u20099, 100%) were strong predictors of major complications after flap re-elevation. Current smoking (OR = 6.39, CI [1.43\u201328.53]) and alcohol use (OR = 9.0, CI [1.92\u201342.40]) were also significant risk factors.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Our findings indicate that the risk of flap failure is primarily associated with patient factors and peri-operative trajectory, rather than flap type alone. We propose minimizing unplanned flap re-elevations or primary complications by selecting a flap that optimally obliterates dead space and provides durable coverage.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/22925503261453079","type":"journal-article","created":{"date-parts":[[2026,5,30]],"date-time":"2026-05-30T09:01:39Z","timestamp":1780131699000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Complications Following Flap Re-Elevation for Secondary Orthopaedic Lower Extremity Procedures: A Comparative Analysis of Muscle and Fasciocutaneous Flaps"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7710-4292","authenticated-orcid":false,"given":"Hedi (Henry)","family":"Zhao","sequence":"first","affiliation":[{"name":"University of British Columbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5852-9685","authenticated-orcid":false,"given":"Shreya","family":"Luthra","sequence":"additional","affiliation":[{"name":"University of British Columbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-5011-5112","authenticated-orcid":false,"given":"Hannah","family":"Wells","sequence":"additional","affiliation":[{"name":"University of British Columbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4502-2644","authenticated-orcid":false,"given":"Erin","family":"Brown","sequence":"additional","affiliation":[{"name":"University of British Columbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas J.","family":"Carr","sequence":"additional","affiliation":[{"name":"University of British Columbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin","family":"Bush","sequence":"additional","affiliation":[{"name":"University of British Columbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Lennox","sequence":"additional","affiliation":[{"name":"University of British Columbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9374-031X","authenticated-orcid":false,"given":"Kathryn V.","family":"Isaac","sequence":"additional","affiliation":[{"name":"University of British Columbia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,5,30]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1002\/micr.30020"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0b013e3182a80925"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0b013e3182046a16"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1093\/burnst\/tkab024"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.2340\/17453674.2025.43446"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2015.12.013"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1002\/micr.30961"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1097\/SAP.0b013e31828a0c3c"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1002\/micr.20696"},{"key":"e_1_3_3_11_2","volume-title":"Clinical applications for muscle and musculocutaneous flaps","author":"Mathes SJ","year":"1982","unstructured":"Mathes SJ, Nahai F. 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