A Pilot Randomized Clinical Trial of Early Ambulation after Groin Reconstruction with Sartorius Muscle Flaps
Background:. The use of muscle flaps, such as the sartorius muscle, for groin coverage in high-risk vascular patients has been shown to reduce complication rates. However, it remains unknown whether earlier postoperative ambulation is associated with improved postoperative outcomes for groin muscle...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer
2022-11-01
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| Series: | Plastic and Reconstructive Surgery, Global Open |
| Online Access: | http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000004665 |
| _version_ | 1811305046649864192 |
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| author | Audrey B. Nguyen, MD Michael A. Kohn, MD, MPP Rachel Lentz, MD Scott L. Hansen, MD |
| author_facet | Audrey B. Nguyen, MD Michael A. Kohn, MD, MPP Rachel Lentz, MD Scott L. Hansen, MD |
| author_sort | Audrey B. Nguyen, MD |
| collection | DOAJ |
| description | Background:. The use of muscle flaps, such as the sartorius muscle, for groin coverage in high-risk vascular patients has been shown to reduce complication rates. However, it remains unknown whether earlier postoperative ambulation is associated with improved postoperative outcomes for groin muscle flaps following infrainguinal vascular surgery.
Methods:. We performed a pilot randomized trial to analyze the effect of early ambulation on postoperative outcomes in patients who had groin reconstruction with sartorius muscle flaps following infrainguinal vascular surgery at our academic institution.
Results:. Fourteen patients were randomized to standard ambulation (on postoperative day 6), and 14 patients were randomized to early ambulation (on postoperative day 2). The treatment arms were similar with respect to age, body mass index, risk category, smoking status, and comorbidities. Median length of stay was 6 days in the early group versus 7 days in the standard group. Immediate and long-term physical function and general health were better in the early group There were slightly more wound complications in the standard (57.1%) versus the early group (42.9%), and the early group had more lymphatic complications (35.7% versus 14.3%).
Conclusions:. The decision to ambulate a patient after this surgery continues to be a decision between the vascular and plastic surgeons. However, this pilot trial has shown the safety profile of early ambulation and that it should be considered for specific patients. Additionally, this trial has provided valuable information for performing a larger scale randomized controlled trial to determine the optimal postoperative protocol for patients with these reconstructions. |
| first_indexed | 2024-04-13T08:18:21Z |
| format | Article |
| id | doaj.art-d7e25ba2bb444f069437f333f6e68fe3 |
| institution | Directory Open Access Journal |
| issn | 2169-7574 |
| language | English |
| last_indexed | 2024-04-13T08:18:21Z |
| publishDate | 2022-11-01 |
| publisher | Wolters Kluwer |
| record_format | Article |
| series | Plastic and Reconstructive Surgery, Global Open |
| spelling | doaj.art-d7e25ba2bb444f069437f333f6e68fe32022-12-22T02:54:42ZengWolters KluwerPlastic and Reconstructive Surgery, Global Open2169-75742022-11-011011e466510.1097/GOX.0000000000004665202211000-00047A Pilot Randomized Clinical Trial of Early Ambulation after Groin Reconstruction with Sartorius Muscle FlapsAudrey B. Nguyen, MD0Michael A. Kohn, MD, MPP1Rachel Lentz, MD2Scott L. Hansen, MD3From the * Division of Plastic and Reconstructive Surgery, University of California San Francisco, San Francisco, Calif.† Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, Calif.From the * Division of Plastic and Reconstructive Surgery, University of California San Francisco, San Francisco, Calif.From the * Division of Plastic and Reconstructive Surgery, University of California San Francisco, San Francisco, Calif.Background:. The use of muscle flaps, such as the sartorius muscle, for groin coverage in high-risk vascular patients has been shown to reduce complication rates. However, it remains unknown whether earlier postoperative ambulation is associated with improved postoperative outcomes for groin muscle flaps following infrainguinal vascular surgery. Methods:. We performed a pilot randomized trial to analyze the effect of early ambulation on postoperative outcomes in patients who had groin reconstruction with sartorius muscle flaps following infrainguinal vascular surgery at our academic institution. Results:. Fourteen patients were randomized to standard ambulation (on postoperative day 6), and 14 patients were randomized to early ambulation (on postoperative day 2). The treatment arms were similar with respect to age, body mass index, risk category, smoking status, and comorbidities. Median length of stay was 6 days in the early group versus 7 days in the standard group. Immediate and long-term physical function and general health were better in the early group There were slightly more wound complications in the standard (57.1%) versus the early group (42.9%), and the early group had more lymphatic complications (35.7% versus 14.3%). Conclusions:. The decision to ambulate a patient after this surgery continues to be a decision between the vascular and plastic surgeons. However, this pilot trial has shown the safety profile of early ambulation and that it should be considered for specific patients. Additionally, this trial has provided valuable information for performing a larger scale randomized controlled trial to determine the optimal postoperative protocol for patients with these reconstructions.http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000004665 |
| spellingShingle | Audrey B. Nguyen, MD Michael A. Kohn, MD, MPP Rachel Lentz, MD Scott L. Hansen, MD A Pilot Randomized Clinical Trial of Early Ambulation after Groin Reconstruction with Sartorius Muscle Flaps Plastic and Reconstructive Surgery, Global Open |
| title | A Pilot Randomized Clinical Trial of Early Ambulation after Groin Reconstruction with Sartorius Muscle Flaps |
| title_full | A Pilot Randomized Clinical Trial of Early Ambulation after Groin Reconstruction with Sartorius Muscle Flaps |
| title_fullStr | A Pilot Randomized Clinical Trial of Early Ambulation after Groin Reconstruction with Sartorius Muscle Flaps |
| title_full_unstemmed | A Pilot Randomized Clinical Trial of Early Ambulation after Groin Reconstruction with Sartorius Muscle Flaps |
| title_short | A Pilot Randomized Clinical Trial of Early Ambulation after Groin Reconstruction with Sartorius Muscle Flaps |
| title_sort | pilot randomized clinical trial of early ambulation after groin reconstruction with sartorius muscle flaps |
| url | http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000004665 |
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