Objective preoperative estimation of the ability of primary closure on anterolateral thigh free flap donor site: Circumference and area ratios of deep tissue to thigh

Microsurgery ◽  
2013 ◽  
Vol 33 (4) ◽  
pp. 270-274 ◽  
Author(s):  
Kyeongho Song ◽  
Subong Nam ◽  
Soojong Choi ◽  
Joohyoung Kim ◽  
Jaewoo Lee ◽  
...  
Keyword(s):  
Free Flap ◽  
Primary Closure ◽  
Donor Site ◽  
Deep Tissue ◽  
Anterolateral Thigh

LONG-TERM DONOR-SITE MORBIDITY IN COMPOSITE ANTEROLATERAL THIGH FREE FLAP FOR COMPLEX DEFECT OF LOWER LEG AND FOOT RECONSTRUCTION

2020 ◽  
pp. 85-91
Author(s):  
Phuc Le Hong ◽  
Son Tran Thiet ◽  
Thuy Nguyen Xuan
Keyword(s):  
Soft Tissue ◽  
Skin Graft ◽  
Free Flap ◽  
Donor Site ◽  
Lower Extremities ◽  
Lower Leg ◽  
Donor Site Morbidity ◽  
Thigh Circumference ◽  
Anterolateral Thigh

Background: In recent years, the composite anterolateral thigh free flap with tensor fasciae latae or vastus lateralis has been a new-applied type of flap that can provide very good reconstruction materials in complex defects of lower leg and foot. The study purpose is to evaluate the systematically complications of donor site, related factors to results of the donor area, in order to apply the result to improve the treatment, which have not been much reported in literature. Materials and Methods: Systematic donor site morbilidy evaluation in a prospective, uncontrolled clinical descriptive study of 33 composite anterolateral thigh free flaps in various forms to reconstruct anatomical structures or to resconstruct deep defects combined with covering the surfaces for complex soft tissue defects in lower extremities for 32 patients due to different causes in lower leg and foot area from 2014-2019 at Hue University of Medicine and Pharmacy. Examining and evaluating aesthetic and functional result of donor-site 3 months and 6 months up to 2 year after surgery; evaluating the correlation between the width and the type of the flaps and donor site closure methods. Result: In 33 composite flaps used, flap width to thigh circumference less than 20% in 27 cases (81.8%), more than 20% in 6 cases (18.20% ); There were 28 cases in which the donor site was directly closed, 5 cases required skin graft; All direct closed cases had flap width/ thigh circumference index below 20%; On the contrary, in cases having this index greater than 20%, the donor site required skin graft with p < 0.01. There are 11/33 (33.33%) of cases reported complications in donor site ; lateral thigh paresthesia is the most complicated complication with 8/33 cases (24.24%), followed by bad scarring 3/33 cases (9.09%). Conclusion: Long term follow up donor site morbility after composite anterior thigh free flap present 11/33 cases (33.33%): mostly complications of the donor site are thigh paresthesia with 8/33 cases (24.24%), and bad scarring 3/33 cases (9,09%), which improve time by time. Keywords: Composite anterior thigh free flap, lower extremities soft tissue defect, donor site morbidity

The proximal first dorsal metacarpal artery free flap for reconstruction of complex digital defects

2012 ◽  
Vol 38 (4) ◽  
pp. 399-404 ◽  
Author(s):  
P. Hyza ◽  
T. Kubek ◽  
J. Vesely ◽  
L. Drazan ◽  
U. Choudry
Keyword(s):  
Patient Satisfaction ◽  
Surgical Technique ◽  
Free Flap ◽  
Primary Closure ◽  
Donor Site ◽  
Free Flaps ◽  
Outcome Data ◽  
Patient Demographics ◽  
Dorsal Metacarpal Artery ◽  
First Dorsal Metacarpal Artery

We describe our experience and outcome with the ‘Proximal first dorsal metacarpal artery free flap’. Ten consecutive cases utilizing the proximal first dorsal metacarpal artery free flap for complex digital defects were studied. Surgical technique, patient demographics, and flap outcome data were collected. Patient satisfaction was analysed using a questionnaire. All defects healed successfully with no loss of free flaps. The short-pedicle proximal first dorsal metacarpal artery free flap enables primary closure of the donor site up to 2 cm of width (in nine of the ten donor sites). The flap is a reliable and versatile alternative in selected cases of complex digital injuries.

scholarly journals Reconstruction of a Large Through and Through Defect of the Oral Cavity Using Double Anterolateral Thigh Free Flap

2014 ◽  
Vol 29 (1) ◽  
pp. 26-29
Author(s):  
Jefferson A. Alamani ◽  
Samantha S. Castañeda ◽  
Adrian F. Fernando
Keyword(s):  
Soft Tissue ◽  
Oral Cavity ◽  
Free Flap ◽  
Donor Site ◽  
Operating Time ◽  
Soft Tissue Defect ◽  
Full Thickness ◽  
Anterolateral Thigh ◽  
Cervical Area ◽  
Alt Flap

Objective: To present our application of a double anterolateral thigh (ALT) free flap in reconstruction of a large full thickness defect of the oral cavity, cheek and cervical area. Methods: Design: Case Report Setting: Tertiary Government Hospital Patient: One Results: A 77-year-old male with a 20 x 25 cm full thickness soft tissue defect on the facial and cervical area contiguous with a 6 x 6 cm buccal defect resulting from wide tumor ablation of a Stage IVA (T4aN2bM0) squamous cell carcinoma of the buccal mucosa underwent reconstruction using two ALT free flaps. An ALT flap was designed to cover the intraoral and cheek defect, while another ALT flap was used for external coverage of the cervical defect. The first ALT flap measured approximately 8 x 22 cm while the second ALT flap measured 6 x 22 cm harvested from the left and right thigh respectively. Temporary venous congestion was observed on the inferiorly placed ALT flap due to neck edema that spontaneously resolved on the 2nd post-operative day. Minimal donor site complications observed were linear scars, and a 1 x 4 cm dehiscence on the right thigh that healed spontaneously by secondary intention.   Conclusion: The utilization of a double anterolateral thigh free flap allowed single-stage reconstruction of the large soft tissue head and neck defect with little donor site morbidity, shorter operating time and shorter hospital stay.   Keywords: anterolateral thigh free flap (ALT flap), double ALT flap, full-thickness buccal defect

scholarly journals Sole Reconstruction Using Anterolateral Thigh Free Flap: A Review of 4 Cases

1970 ◽  
Vol 2 (3) ◽  
Author(s):  
Parintosa Atmodiwirjo ◽  
Afriyanti Sandhi
Keyword(s):  
Free Flap ◽  
Weight Bearing ◽  
Donor Site ◽  
Three Dimensional ◽  
Free Flaps ◽  
Donor Site Morbidity ◽  
Common Procedure ◽  
Anterolateral Thigh ◽  
Protective Sensation ◽  
And Function

Background: The ideal technique for sole reconstruction should meet such requisite as a durable and comfortable weight-bearing surface, solid anchoring to deep tissue for resistance to shear force and adequate protective sensation. The anterolateral thigh (ALT) perforator free flap provides a large, pliable skin island and sufficient bulk, allowing three-dimensional tailoring to complex defects. The present article is about our experience of sole reconstruction ALT perforator free flap. Patient and Method: Total of 4 flaps in the foot defects was performed in February 2009 to December 2012. We reconstructed soft tissue defects in the sole using ALT free flaps, the complications, aesthetic and function results were monitored. Result: ALT perforator free flap provided stable and durable long-term wound cover in all patients, resulting in early rehabilitation and function outcomes were completely achieved. Complications were few and manageable in all cases. Summary: ALT perforator free flap has become common procedure in many centers around the world. The numerous advantages include stable wound coverage; improve aesthetic and functional outcomes, and minimal donor site morbidity. In our experiences, we found that the use of ALT perforator free flap in sole defect reconstruction, to be technically affordable, reliable and have resulted in excellent outcomes.

scholarly journals A simple and cost-effective protocol for the management of anterolateral thigh free-flap donor site

2008 ◽  
Vol 41 (02) ◽  
pp. 235-236
Author(s):  
Tuli Puneet ◽  
Biswas Gautam ◽  
Parashar Atul ◽  
K. Sharma Ramesh
Keyword(s):  
Free Flap ◽  
Donor Site ◽  
Cost Effective ◽  
Anterolateral Thigh

Anterolateral Thigh Flap for Skull Base Reconstruction

2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P30-P30
Author(s):  
Matthew M Hanasono ◽  
Neha Goel ◽  
Martina Ayad ◽  
Roman Skoracki ◽  
Justin Michael Sacks
Keyword(s):  
Skull Base ◽  
Free Flap ◽  
Donor Site ◽  
Csf Leak ◽  
Anterolateral Thigh Flap ◽  
Wound Complications ◽  
Skull Base Reconstruction ◽  
Anterolateral Thigh ◽  
Facial Reanimation ◽  
Skull Base Defects

Objective 1) Review our experience with the anterolateral thigh (ALT) free flap in skull base reconstruction. 2) Describe reconstructive techniques for skull base defects and dural coverage with simultaneous facial reanimation. Methods A retrospective review was performed for 25 consecutive patients with defects of the skull base who were reconstructed with the ALT free flap. Results Reconstructed sites consisted of 2 anterior, 7 lateral, and 16 posterior skull base defects. Neoadjuvant and adjuvant radiotherapy (RT) was administered to 32% and 36% of the patients, respectively. The overall complication rate was 36% (66% recipient site and 34% donor site). One patient developed a CSF leak and one a nasocutaneous fistula. RT was associated with a two-fold increase in wound complications relative to controls. There were no flap losses and no long-term donor site probleMS 3 nerve grafts using the lateral femoral cutaneous nerve and 12 static slings for facial reanimation using the tensor fascia lata were performed simultaneously with free flap reconstruction from the same donor site. 4 gold eyelid weights, 2 lateral canthoplasties, and 3 direct browlifts were also performed simultaneously. Conclusions The ALT free flap provides reliable and versatile reconstruction of skull base defects. Primary advantages of this flap reside in the ability to harvest variable amounts of skin and vastus lateralis muscle along with nerve and fascial grafts from the same operative site, minimizing operative time and donor site morbidity. In our practice, the ALT flap represents a first-line option for composite skull base defects.

scholarly journals Utilization of a Continuous External Tissue Expansion System to Assist in Primary Closure of a Large Anterolateral Thigh Donor Site Defect

2014 ◽  
Vol 2014 ◽  
pp. 1-3
Author(s):  
Andrew G. Silver ◽  
Richard C. Baynosa
Keyword(s):  
Primary Closure ◽  
Donor Site ◽  
Tissue Expansion ◽  
Skin Grafting ◽  
Flap Coverage ◽  
Anterolateral Thigh ◽  
Expansion System ◽  
Donor Site Defect ◽  
Alt Flap

Primary closure of a large anterolateral thigh (ALT) flap donor site defect with the assistance of an external tissue expansion system is presented. The dimensions of this donor site (12 cm × 40 cm) and its percentage of leg circumference (34%) would make this site likely to require skin grafting or further flap coverage based on the results of previously published literature.

Comparison of anterolateral thigh and radial forearm free flap donor site morbidity

Microsurgery ◽  
2007 ◽  
Vol 27 (8) ◽  
pp. 651-654 ◽  
Author(s):  
Christine B. Novak ◽  
Joan E. Lipa ◽  
Sabrena Noria ◽  
Keith Allison ◽  
Peter C. Neligan ◽  
...  
Keyword(s):  
Free Flap ◽  
Donor Site ◽  
Donor Site Morbidity ◽  
Radial Forearm Free Flap ◽  
Anterolateral Thigh ◽  
Radial Forearm
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