Rhomboid flap scar assessment: A patient reported outcome study. A case series

Abstract

Introduction and importanceLocal skin flap techniques, including rhomboid flap, have been developed to reconstruct cutaneous defects. Rhomboid flap advantages include easy design, excellent contour, texture, thickness, color match, and long-term good cosmesis. There is no patient reported outcome study in literature detailing patients’ perception of appearance and satisfaction of scar appearance. MethodsWe studied 100 consecutive rhomboid flaps performed in 73 patients by a single surgeon. After at least one year from flap completion, a validated published Patient Scar Assessment Questionnaire (PSAQ) by Durani et al. was completed for each flap. ResultsThe median age was 73 years, with a range of 21 years–94 years. Gender breakdown was 65 flaps in males and 35 flaps in females. For appearance, there were significantly greater frequency of “very well-matched scar” patients compared to “well-matched scar” patients (p < 0.001). There were no “a little matched” or “poorly matched” patients. For satisfaction of appearance scores, there were significantly greater frequency of “very satisfied” patients compared to “satisfied” patients (p < 0.001). There were no “dissatisfied” or “very dissatisfied” patients. Although size of primary defect was not statistically significant (p 0.071), there was a trend towards better appearance scar match and scar satisfaction for smaller defects. Age was not statistically significant (p 0.086), there was a trend towards better appearance scar match and scar satisfaction among older patients. There was no significant difference in appearance match and satisfaction scores based on the gender (p 0.733). There were no post-operative complications. ConclusionsOur study confirms, in experienced hands, the long-term patient perception of well-matched scar appearance and scar satisfaction with rhomboid flap technique. A significantly greater frequency of patients were “very satisfied” than “satisfied”, with no “dissatisfied” patients. There was no statistically significant difference based on age, gender, and size of the primary defect.