Objective: This study was performed to evaluate two classic procedures guided by anatomic markers for harvesting the anterolateral thigh (ALT) flap: one began with an incision on the lateral side to identify perforators emerging from the muscle to the superficial tissue and to track the perforators upward to the upper stem vessel, and the other began with an incision on the medial side to identify the vessel branch from the stem artery and to track it downward to the flap perforators.
Methods: Twenty-eight consecutive patients with tissue defects repaired with ALT flaps were investigated; 13 and 15 patients underwent the lateral and medial incision technique, respectively. The surgeon's subjective view regarding procedural difficulty and the operative times were statistically analyzed.
Results: All flaps were harvested successfully. A two-paddle flap from one thigh in the medial group failed due to necrosis; all others survived completely. Subjectively, harvesting of flaps starting with a lateral incision was somewhat difficult, and the operative time was significantly longer using the lateral technique.
Conclusions: Classic procedures to harvest the anterolateral thigh flap are still practicable, and starting with a medial incision is more efficient than starting with a lateral incision. Type of study/level of evidence: Therapeutic IV.
Download full-text PDF |
Source |
---|---|
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6259386 | PMC |
http://dx.doi.org/10.1177/0300060518786912 | DOI Listing |
JPRAS Open
March 2025
Department of Plastic & Reconstructive Surgery, Hospital Universitario Son Espases, Palma de Mallorca, Balearic Islands, Spain.
Introduction: Extensive scalp defects present a significant reconstructive challenge due to the complex needs of patients that are often beyond the scope of conventional therapies, which makes free flaps the most reliable solution. Despite the variety of free flaps available for such cases, there is a lack of clear criteria for selecting the most suitable option. The primary objective of this study was to provide a simplified guide for the selection of donor sites for free flaps for achieving optimal reconstruction outcomes.
View Article and Find Full Text PDFOtolaryngol Head Neck Surg
January 2025
Section of Facial Plastic and Microvascular Surgery, Cleveland Clinic, Cleveland, Ohio, USA.
Objective: Describe the use, indications, and outcomes of iliac crest bone graft (ICBG) with concomitant anterolateral thigh fascia lata (ALTFL) rescue flap for the management of mandibular osteoradionecrosis (ORN).
Study Design: Retrospective chart review.
Setting: Single institution.
Microsurgery
January 2025
Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Thinning of anterolateral thigh flap is challenging. Anatomical studies have shown variations in arterial branching patterns in the subcutaneous layer, which were suspected to be the reason for the high frequency of thinning failures. We attempted to visualize subcutaneous arterial courses preoperatively and perform thinning of perforator flaps using this information appropriately.
View Article and Find Full Text PDFJ Korean Assoc Oral Maxillofac Surg
December 2024
Department of Oral and Maxillofacial Surgery, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Korea.
It is crucial to reconstruct extensive soft tissue defects following oral cancer resection to restore both function and aesthetics. Single anterolateral thigh flaps may not suffice for large defects. This report highlights the use of chimeric flaps, which feature multiple paddles with individual perforators, to reconstruct large intraoral and extraoral defects, adapting to wide defects, and covering areas with extensive tissue damage.
View Article and Find Full Text PDFIndian J Plast Surg
December 2024
Department of Burns and Plastic Surgery, Atal Bihari Vajpayee Institute of Medical Sciences, Dr. Ram Manohar Lohia Hospital, New Delhi, India.
We present the case of a 36-year-old male patient with a posttraumatic composite defect of the lower two-thirds of the anterior aspect of the left leg with exposed necrotic tibia in an old, neglected type 3b fracture of the tibia of 9-month duration. The options for definitive soft-tissue cover include microvascular free tissue transfer and cross-leg flaps. In trauma cases, the surrounding tissue is usually damaged, and the recipient vessels are frequently implicated, ruling out the use of a microvascular free flap.
View Article and Find Full Text PDFEnter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!