Results at the donor site after free microvascular iliac crest transplantation

Abstract

The anterior iliac crest is used frequently as a donor site for free osseous, osteomuscular and osteomyocutaneous flaps in reconstructive maxillofacial and orthopedic surgery. A long-term retrospective study of the donor site after vascularized free anterior iliac crest transfer in 103 patients is presented. The patients were examined for objective complications and questioned about their subjective symptoms at the donor site. Objective and subjective results were then correlated: 2.8% of the patients developed hernias, 8.6% showed a loss of sensation in the area of the lateral cutaneous femoral nerve, which disappeared spontaneously in two-thirds of the patients, and 8.6% had unsatisfactory scars, but did not have hypertrophic scars or keloids. All wounds healed primarily. One fourth of the patients presented with minor alterations in the contour of the donor site, and 9.5% of cases had pain in the donor area. Impairment in private life occurred in 3.8%, in professional life in 4.8%, and in daily life in 12.3% of cases. Of the patients 13.3% were dissatisfied with the situation of the donor site, while 12.3% of those interviewed were not satisfied with the preoperative information they were given. Nonetheless, 98.1% of the patients would be willing to undergo the same operative procedure again, if necessary.