378 Comparison of Outcomes Between Early and Delayed Weight Bearing Following Lower Limb Free Flaps

Abstract

Abstract Aim Post-operative protocols following lower limb free flap surgery are not well defined with a lack of consensus in the literature around limb dependency and weight bearing. The aim was to compare the complication rate for lower limb free flaps before and after the introduction of an enhanced lower limb free flap protocol with earlier dangling (day 3 vs day 4) and weight bearing (day 5 vs day 14) post lower limb free flap surgery. Method All lower limb free flaps between June 2020-October 2021 were identified from a departmental flap database. Patient data was collected retrospectively from the comprehensive lower limb free flap database, medical notes and electronic records. Exclusion criteria was any patient prescribed non-weight bearing due to the method of bone fixation. Results A total of 30 patients, 14 pre- and 16 post-enhanced protocol were identified for comparison. Mean age was 43 (17–72) with a M:F of 2:1 and RTC as the most common mechanism of injury. There was no difference in the type of flap reconstruction between groups, with the anterolateral thigh flap the most common in both groups. No differences were identified in the number of complications related to dependency/weight bearing before and after the introduction of the enhanced protocol, with mean length of stay reduced from 12 to 11 days. Conclusions The new enhanced protocol remains the standard of care in our unit, as we demonstrated a reduction in length of stay with no difference in complication rates following lower limb free flap surgery.