From an esthetic perspective, we need to choose color-matched and texture-matched flaps for reconstruction of exposed parts. We reviewed flap surgical procedures and evaluated the final appearance in free flap reconstruction of exposed parts over the last decade.
Sixty patients with lesions of exposed parts underwent free flap reconstructions between 2002 and 2011. There were 32 males and 28 females. The average age was 40 years. The lesions were located in fifteen head and neck parts, eleven lower thigh parts, and nine foot parts, among others. Thirty patients received free latissimus dorsi flaps, ten free fibula flaps, and nine free anterolateral thigh flaps, among others. Average follow-up period was 50 months. Final appearances were scored out of four in terms of meshed skin graft, unevenness, and color match, and finally classified into four grades: excellent, good, fair, and poor.
The survival rate of free flaps was 93.5%. Twenty-four patients required additional surgical procedures, such as defatting and scar revision. Esthetic results were excellent in eight, good in sixteen, fair in twelve, and poor in five.
The final appearance was quite good, as the percentage of excellent and good results was approximately 60%. However, we need to continue to improve the esthetic results.
