title: Comparison between anterolateral thigh, radial forearm, and peroneal artery flap donor site thickness in Asian patients-A sonographic study.
abstract: OBJECTIVE
  This study aimed to determine the thicknesses of the three locations used as donor sites for radial forearm (RF), anterolateral thigh (ALT), and peroneal flaps and to determine probable contributing factors of the thickness.
  
  
  METHODS
  This study included 201 healthy participants (mean age: 45.8 ± 17.2 years; male: 114; female: 87; BMI: 24.3 ± 4.3). Sonography was used to measure the thickness of flap donor sites. Forward stepwise regressions were conducted to determine the contributing factors of flap thickness.
  
  
  RESULTS
  The RF flap (0.28 ± 0.08 cm) was thinner than peroneal flap (0.47 ± 0.17 cm) (P < 0.0001), and peroneal flap was thinner than ALT flap (0.98 ± 0.4 cm) (P < 0.0001). Flap type (P < 0.001, 95%CI: 0.33-0.41), BMI (P < 0.001, 95%CI: 0.02-0.033), gender (P < 0.001, 95%CI: -0.3 to -0.17), and age (P = 0.002, 95%CI: -0.005 to -0.001) were the contributing factors of flap thickness. In the subgroup analysis, BMI was the only contributing factor of RF flap thickness (P < 0.001). For ALT and peroneal flaps, age, gender, and BMI were the contributing factors (P < 0.001). The coefficient of BMI was 0.005 in RF flap, 0.01 in peroneal flap, and 0.04 in ALT flap.
  
  
  CONCLUSIONS
  The RF flap was found thinner than peroneal flap, and peroneal flap was found thinner than ALT flap. The BMI effects on RF and peroneal flaps were much less than that on ALT flap. Therefore, the RF and peroneal flaps would be the better choice in obese patients with soft tissue defects where a thin flap is needed.
authors.affiliation: Division of Plastic and Reconstructive Surgery, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan 813, Republic of China.|Department of Surgery, National Defense Medical Center, Taipei, Taiwan.
authors.forename: Kuei-Chang
authors.initials: KC
authors.lastname: Hsu
authors.affiliation: Division of Plastic and Reconstructive Surgery, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan 813, Republic of China.
authors.forename: Wei-Hsuan
authors.initials: WH
authors.lastname: Tsai
authors.affiliation: Division of Plastic and Reconstructive Surgery, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan 813, Republic of China.
authors.forename: Pei-San
authors.initials: PS
authors.lastname: Ting
authors.affiliation: Division of Plastic and Reconstructive Surgery, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan 813, Republic of China.
authors.forename: Jung-Hua
authors.initials: JH
authors.lastname: Hsueh
authors.affiliation: Division of Plastic and Reconstructive Surgery, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan 813, Republic of China.
authors.forename: Lee-Wei
authors.initials: LW
authors.lastname: Chen
authors.affiliation: Division of Plastic and Reconstructive Surgery, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan 813, Republic of China.
authors.forename: Ying-Sheng
authors.identifier: http://orcid.org/0000-0002-4499-0881
authors.initials: YS
authors.lastname: Lin
mesh_terms: D000046:Academic Medical Centers; D000328:Adult; D015331:Cohort Studies; D005260:Female; D005542:Forearm / Q000098:blood supply / Q000601:surgery; D006084:Graft Rejection; D006085:Graft Survival; D064368:Healthy Volunteers; D006801:Humans; D008297:Male; D008866:Microsurgery / Q000379:methods; D008875:Middle Aged; D019651:Plastic Surgery Procedures / Q000379:methods*; D012044:Regression Analysis; D012189:Retrospective Studies; D013524:Surgical Flaps / Q000098:blood supply*; D013624:Taiwan; D013848:Thigh / Q000098:blood supply / Q000601:surgery; D014019:Tissue Donors; D060053:Transplant Donor Site / Q000000981:diagnostic imaging* / Q000473:pathology*; D014463:Ultrasonography / Q000379:methods; D055815:Young Adult