title: Donor-site morbidity following harvest of the transverse myocutaneous gracilis flap for breast reconstruction.
abstract: BACKGROUND
  The transverse myocutaneous gracilis flap provides adequate autologous tissue for breast reconstruction from the high thigh region, but flap harvest may affect the patient's activities of daily living, sexuality, and quality of life. The authors evaluated the reconstruction outcome, postoperative donor-site complications, and quality-of-life outcomes.
  
  
  METHODS
  All patients who underwent transverse myocutaneous gracilis breast reconstruction performed by the senior author (M.H.) since 2007 were included in the study. Patient files were reviewed, and a questionnaire was used to assess patient satisfaction.
  
  
  RESULTS
  Forty-nine transverse myocutaneous gracilis flaps were performed in 36 patients for breast reconstruction. Total flap necrosis occurred in two flaps (4 percent). Additional fat grafting was required in 61 percent of flaps, and donor-site complications occurred in 59 percent of patients. Wound dehiscence and infection were the most commonly encountered donor-site complications. However, by harvesting less skin and gracilis muscle, there was a statistically significant (p<0.001) lower complication rate in the last 16 patients. Twenty-two patients with at least 6 months of follow-up were included in the questionnaire study. Eighteen returned questionnaires. Most patients were happy to very happy with their result and could go about their activities of daily living. There was no statistically significant correlation between the independent variables (e.g., age, body mass index, and radiotherapy) and the dependent variables (e.g., breast satisfaction, sexuality, and donor-site morbidity). There was a statistically significant difference regarding donor-site satisfaction when comparing patients with and without donor-site complications (p=0.01).
  
  
  CONCLUSIONS
  Although fat grafting was often required, patients were happy with the result of their transverse myocutaneous gracilis breast reconstruction. Donor-site complications correspondence inversely to patient satisfaction.
  
  
  METHODS
  Therapeutic, IV.
authors.affiliation: Brussels, Belgium From the Departments of Plastic and Reconstructive Surgery and Medical Statistics, Brussels University Hospital; and the Department of Biomedical Statistics and Information Technology, Free University of Brussels (Vrije Universiteit Brussel VUB).
authors.forename: Barbara
authors.initials: B
authors.lastname: Craggs
authors.forename: Bert
authors.initials: B
authors.lastname: Vanmierlo
authors.forename: Assaf
authors.initials: A
authors.lastname: Zeltzer
authors.forename: Ronald
authors.initials: R
authors.lastname: Buyl
authors.forename: Patrick
authors.initials: P
authors.lastname: Haentjens
authors.forename: Moustapha
authors.initials: M
authors.lastname: Hamdi
mesh_terms: D000328:Adult; D001943:Breast Neoplasms / Q000473:pathology / Q000601:surgery*; D015331:Cohort Studies; D004954:Esthetics; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection; D006085:Graft Survival; D006801:Humans; D007902:Length of Stay; D016462:Mammaplasty / Q000009:adverse effects / Q000379:methods*; D008408:Mastectomy / Q000009:adverse effects / Q000379:methods; D008875:Middle Aged; D064827:Myocutaneous Flap / Q000601:surgery / Q000637:transplantation*; D011183:Postoperative Complications / Q000503:physiopathology / Q000628:therapy; D012189:Retrospective Studies; D018570:Risk Assessment; D011795:Surveys and Questionnaires; D013848:Thigh / Q000601:surgery; D020858:Tissue and Organ Harvesting; D060053:Transplant Donor Site / Q000503:physiopathology* / Q000601:surgery; D014182:Transplantation, Autologous; D016896:Treatment Outcome; D014945:Wound Healing / Q000502:physiology