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Laser Scanning Evaluation of Atrophy After Autologous Free Muscle Transfer

Wettstein, Reto MD*; Largo, René D. MD*; Raffoul, Wassim MD; Schumacher, Ralf MAS; Schaefer, Dirk J. MD*; Kalbermatten, Daniel F. MD, PhD*

doi: 10.1097/SAP.0b013e318268a8cc

Denervated muscle tissue undergoes morphologic changes that result in atrophy. The amount of muscle atrophy after denervation following free muscle transfer has not been measured so far. Therefore, the amount of muscle atrophy in human free muscle transfer for lower extremity reconstruction was measured in a series of 10 patients. Three-dimensional laser surface scanning was used to measure flap volume changes 2 weeks as well as 6 and 12 months after the operation. None of the muscles transferred was re-innervated.

All muscles healed uneventfully without signs of compromised perfusion resulting in partial flap loss. The muscle volume decreased to 30 ± 4% and 19 ± 4% 6 and 12 months, respectively, after the operation, ie, the volume decreased by approximately 80% within a 12-month period.

Denervated free muscle flap tissue undergoes massive atrophy of approximately 80%, mostly within the first 6 months.

From the *Department of Plastic, Reconstructive, Aesthetic and Hand Surgery, University Hospital of Basel, Basel, †Department of Plastic, Reconstructive and Aesthetic Surgery, Burn Unit, CHUV, Lausanne; and ‡Institute for Medical and Analytical Technologies, University of Applied Sciences, Northwestern Switzerland, Muttenz, Switzerland.

Received April 26, 2012, and accepted for publication, after revision, July 8, 2012.

Conflicts of interest and sources of funding: none declared.

Reprints: Reto Wettstein, MD, Department of Plastic, Reconstructive, Aesthetic and Hand Surgery, University Hospital Basel, Spitalstrasse 21, CH-4031 Basel, Switzerland. E-mail:

© 2014 by Lippincott Williams & Wilkins