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J Reconstr Microsurg
DOI: 10.1055/a-2737-5287
Original Article

The Use of Artificial Intelligence in Responding to Patient Questions About Anterolateral Thigh Flap Surgery for Diabetic Foot Ulcers

Authors

  • Luke J Llaurado

    1   Plastic Surgery, Georgetown University School of Medicine, Washington, United States (Ringgold ID: RIN12230)

  • Kishan S. Shah

    1   Plastic Surgery, Georgetown University School of Medicine, Washington, United States (Ringgold ID: RIN12230)

  • Isabel A. Snee

    1   Plastic Surgery, Georgetown University School of Medicine, Washington, United States (Ringgold ID: RIN12230)

  • Rachel N Rohrich

    2   Department of Plastic and Reconstructive Surgery, MedStar Georgetown University Hospital, Washington, United States (Ringgold ID: RIN71541)

  • Ryan J. Bender

    2   Department of Plastic and Reconstructive Surgery, MedStar Georgetown University Hospital, Washington, United States (Ringgold ID: RIN71541)

  • Nicole C. Episalla

    2   Department of Plastic and Reconstructive Surgery, MedStar Georgetown University Hospital, Washington, United States (Ringgold ID: RIN71541)

  • Richard C. Youn

    3   Plastic and Reconstructive Surgery, MedStar Georgetown University Hospital, Washington, United States (Ringgold ID: RIN71541)

  • Karen K Evans

    3   Plastic and Reconstructive Surgery, MedStar Georgetown University Hospital, Washington, United States (Ringgold ID: RIN71541)
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Background: Diabetic foot ulcer (DFU) care represents a significant challenge in plastic and reconstructive surgery. Oftentimes, patients encounter complex articles and websites to answer questions about their surgeries, including Anterolateral Thigh (ALT) flaps. Artificial intelligence (AI) represents a new and simplified resource for DFU patients seeking information regarding their care. To assess ChatGPT’s utility as a patient resource, we evaluated the accuracy, comprehensiveness, and safety of AI-generated responses to frequently asked questions (FAQs) related to ALT flap surgery for DFU. Methods: Ten DFU and ALT flap care FAQs were posed to ChatGPT Model 3.5 in June 2024. Four plastic surgeons evaluated responses using a 10-point Likert scale for accuracy, comprehensiveness, and danger of ChatGPT's answers. Surgeons also provided qualitative feedback. Response readability was assessed using 10 readability indexes, averaged to produce a reading grade level for each response. Results: Overall, ChatGPT answered patient questions with a mean accuracy of 9.1 ± 1.2, comprehensiveness of 8.2 ± 1.5, and danger of 2.0 ± 1.0. ChatGPT answered at a mean grade level of 19.8 ± 20.1. Qualitatively, physician reviewers complimented the organizational clarity of the responses (n=4/10) and the AI’s ability to provide information on possible surgical complications (n= 4/10). While 1 response was noted to present explicitly incorrect information about pre-operative preparation protocols and when they should be initiated, the majority of responses (n=6/10) left out key post-operative information, notably dangle protocols and compression. Conclusion: ChatGPT provides accurate and comprehensive responses to FAQs related to patients undergoing ALT flap surgery for the treatment of DFUs. The AI-generated responses were praised for organizational clarity and informative content regarding surgical complications, but lacked essential post-operative care details. Therefore, while ChatGPT is a valuable informational tool, further refinement is necessary to ensure fully comprehensive information is provided to DFU patients.



Publication History

Received: 03 July 2025

Accepted after revision: 03 November 2025

Accepted Manuscript online:
05 November 2025

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