The anterolateral thigh (ALT) flap is a popular flap for lower extremity reconstruction despite its varied pedicle anatomy. Beyond its use for soft tissue coverage, using the chimeric flap concept, the ALT flap is useful for tendon and ligament reconstruction and the creation of a gliding surface with the fascia lata component. The vastus lateralis muscle can be included for dead-space obliteration. The main pedicle is long and is a similar size match for major artery reconstruction. If several perforators are available, a split flap could be fashioned into a multitude of shapes all arising from the same pedicle.
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http://dx.doi.org/10.1016/j.cps.2020.12.008 | 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.
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