title: Donor-site Morbidity of Medial and Lateral Thigh-based Flaps: A Comparative Study.
abstract: BACKGROUND
  Free and pedicled medial and lateral thigh-based flaps are common reconstructive procedures. However, there have been no comparative studies of morbidity between medial and lateral donor sites.
  
  
  METHODS
  We conducted an Enterprise Data Warehouse-based review of all the senior authors' (R.D.G., G.A.D., and M.S.A.) thigh-based free and pedicled flaps. Patient demographic data, donor-site complications, drain duration, and number of postoperative visits were collected and compared. Complications were also compared between fasciocutaneous flaps and muscle or myocutaneous flaps, and skin grafted donor sites.
  
  
  RESULTS
  We analyzed 352 flap donor sites, with 155 medial and 197 lateral. Two hundred seventeen (217) flaps were pedicled. Flap types included 127 gracilis, 27 rectus femoris, 134 anterolateral thigh, and 36 vastus lateralis-only flaps. There were no significant differences in complications between medial (17.4%) and lateral thigh (21.3%) donor sites, although lateral thigh flaps had a mean of 1 additional postoperative visit. Rates of wound dehiscence/healing issues were significantly higher in both gracilis myocutaneous flaps (25.9%) and flaps requiring a skin grafted donor site (31.2%). Postoperative therapeutic anticoagulation was the only significant risk factor for a donor-site complication. Flap complications resulted in increased drain duration and postoperative office visits.
  
  
  CONCLUSIONS
  Donor-site morbidity is similar in both lateral and medial thigh-based flaps. The inclusion of muscle in the flap from either donor site does not seem to increase complications, but the inclusion of a skin paddle with gracilis muscle, or a skin grafted lateral thigh donor site, results in increased wound healing complications.
authors.affiliation: Division of Plastic Surgery, Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, Ill.; and Department of Plastic and Reconstructive Surgery, Johns Hopkins University, Baltimore, Md.
authors.forename: Chad A
authors.initials: CA
authors.lastname: Purnell
authors.affiliation: Division of Plastic Surgery, Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, Ill.; and Department of Plastic and Reconstructive Surgery, Johns Hopkins University, Baltimore, Md.
authors.forename: Kevin C
authors.initials: KC
authors.lastname: Lewis
authors.affiliation: Division of Plastic Surgery, Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, Ill.; and Department of Plastic and Reconstructive Surgery, Johns Hopkins University, Baltimore, Md.
authors.forename: Lauren M
authors.initials: LM
authors.lastname: Mioton
authors.affiliation: Division of Plastic Surgery, Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, Ill.; and Department of Plastic and Reconstructive Surgery, Johns Hopkins University, Baltimore, Md.
authors.forename: Philip J
authors.initials: PJ
authors.lastname: Hanwright
authors.affiliation: Division of Plastic Surgery, Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, Ill.; and Department of Plastic and Reconstructive Surgery, Johns Hopkins University, Baltimore, Md.
authors.forename: Robert D
authors.initials: RD
authors.lastname: Galiano
authors.affiliation: Division of Plastic Surgery, Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, Ill.; and Department of Plastic and Reconstructive Surgery, Johns Hopkins University, Baltimore, Md.
authors.forename: Gregory A
authors.initials: GA
authors.lastname: Dumanian
authors.affiliation: Division of Plastic Surgery, Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, Ill.; and Department of Plastic and Reconstructive Surgery, Johns Hopkins University, Baltimore, Md.
authors.forename: Mohammed S
authors.initials: MS
authors.lastname: Alghoul