The Anterolateral Thigh Flap: Clinical Applications and Review of the Literature
Journal Title: Biomedical Journal of Scientific & Technical Research (BJSTR) - Year 2018, Vol 7, Issue 2
Abstract
The anterolateral thigh (ALT) flap has gained popularity in reconstructive surgery in recent years as its advantages have come to be widely recognized. We report the senior author’s experience over a five-year period with the use of the ALT flap. The ALT flap is a highly versatile flap that can be used to reconstruct a variety of defects. The flap’s concealed donor site scar, decreased need for skin grafting, decreased donor site morbidity and great versatility make it a first-line option for many different types of defects. Free tissue transfer for the repair of complex defects is a mainstay of modern reconstructive surgery [1]. Reconstruction with the anterolateral thigh (ALT) flap was first described by Song and colleagues as a septocutaneous flap [2]. However, studies have shown that in the majority of cases, the vascular supply arises from musculocutaneous perforators through the vastus lateralis from the descending or transverse branches of the lateral circumflex femoral artery (LCFA) or the LCFA itself [3-9]. The ALT offers the advantages of a long and robust pedicle [5,6,10,11], a significant volume of soft tissue [9,12,13], the option of a sensate flap [14,15], a pedicled option for regional reconstruction [16-20], and the ability to operate using a two-team approach with no patient repositioning. In addition, the flap offers an excellent donor site aesthetic result when closed primarily. Due to these advantages, the ALT flap has become a workhorse for reconstruction of the head and neck [21-23], extremity [24-26], trunk [27-29], and perineum [17,30-35]. Potential pitfalls of the ALT flap include an extended operating time due to delicate dissection of musculocutaneous perforators [10] and poor aesthetic outcome if the donor site requires a skin graft. We present a single surgeon clinical experience in the reconstruction of complex defects using the ALT flap and highlight the flap’s extremely versatile features. Method We prospectively collected data of all patients who underwent ALT flap reconstruction over a 5 year period for any reconstruction of any complex wound. We evaluated age, indications, composition, complications, and outcomes. Patients were evaluated post- operatively for complications, recovery of function, return to work, and resumption of sporting activities. For patients undergoing genitoperineal reconstruction, return to sexual activity and normal urination were also evaluated.
Authors and Affiliations
Peter L Deptula, Travis J Miller, Lawrence Z Cai, Gordon K Lee
Keywords
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- EP ID EP592707
- DOI 10.26717/BJSTR.2018.07.001473
- Views 174
- Downloads 0
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