Free Flap Donor Site Preference: A Surrogate Study
Bibliographic record
Abstract
The objective of this study was to determine which free tissue flap donor sites are preferred, in order to optimize patient satisfaction following reconstructive head and neck surgery. The design was a prospective survey at the University of Toronto Medical School. Two hundred sixty-six junior medical students participated (121 males, 145 females, mean age range 18–35 years), with the following cultural representation: Asian (21.3%), English (18.3%), European (17.5%), Indian (13.7%), Jewish (11.0%), mixed (8.7%), Arab (4.6%), African (4.6%), French (1.1%), West Indian (1.1%), Latin American (0.4%). The students completed a Free-Flap Preference Survey after being shown pre- and postoperative images of 4 reconstructive flaps: anterolateral thigh, scapular, radial forearm, and pectoralis myocutaneous. The main outcome measures were mean preference rating scores. Overall, the medical students ranked the chest as the most preferred body site, followed by the arms, back, and then legs. The back, legs, chest, and arms were ranked with decreasing importance as an acceptable area for a defect. After being shown the pre- and postoperative flap images, the medical students gave the highest rank to the scapular free flap, with the anterolateral thigh, radial forearm, and pectoralis myocutaneous flaps following with decreasing importance. Overall, choice in free-flap preference followed a similar pattern. No significant differences in preference were noted between males and females or between major cultural groups. Scapular and anterolateral thigh free flaps were ranked highest among medical students contemplating donor-site scars. With increasing numbers of surgeons capable of harvesting free flaps from several areas around the body, consideration of patient free-flap preference may improve quality of life outcome scores.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.005 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".