The Boomerang Thigh Flap: Optimizing the Donor Site for an Extended Skin Island Flap

2018 ◽  
Vol 34 (08) ◽  
pp. 658-668 ◽  
Author(s):  
Alex Fioravanti ◽  
Luiz Borges ◽  
Chelsea Snider ◽  
Guilherme Barreiro
Keyword(s):  
Donor Site ◽  
Island Flap ◽  
Anterolateral Thigh Flap ◽  
Anatomical Landmarks ◽  
Reliable Technique ◽  
Circumflex Femoral Artery ◽  
Skin Island ◽  
Clinical Series ◽  
Lateral Circumflex Femoral ◽  
Skin Island Flap

Background The anterolateral region of the thigh is one of the most used donor areas for flaps. However, there are cases in which large defects require more than the conventional skin island provided by the anterolateral thigh flap (ALT). For an extended skin island flap, we developed a new boomerang thigh flap (BTF), in which a boomerang design includes perforators from multiple branches of the lateral circumflex femoral artery (LCFA), providing a single-pedicle, large, reproducible, and reliable flap. We report the anatomical study and the use of the new BTF in a clinical series. Methods We dissected 20 flaps in fresh cadavers to determine the anatomical landmarks, vascular pedicle pattern, perforator distribution, and BTF flap dissection technique. After achieving a reproducible and reliable technique, with primary closure of the donor site based on the pinch test, the BTF was applied for microsurgical reconstructions in the head and neck, lower limb, and upper limb regions. Results The BTF corresponds to a 45° confluence of the ALT and the tensor fascia lata (TFL) elliptical skin islands. It includes the perforators from the transverse/ascending and the descending branches of the LCFA , which conjoined into a single arterial LCFA pedicle in 85% (17) of the cadaver dissections. All the venous branches drained into a single lateral circumflex femoral vein. ALT perforator distribution followed literature descriptions, while TFL perforators were mainly septocutaneous and projected into a virtual rectangle of 6 × 4 cm at the lateral margin of the TFL. Average BTF dimensions were 40 × 8.6 cm. For the clinical cases, flap dimensions and pedicle characteristics were equivalent to the anatomical findings. The BTF was separated into two skin islands in four cases and no major complications were reported. Conclusion The BTF is a reliable, reproducible, and divisible flap that provides extended skin island for reconstruction of large defects.

Perforator-Pedicled Skin Island Flap for Coverage of Microvascular Anastomoses in Myocutaneous Flaps in the Lower Extremity

2003 ◽  
Vol 112 (5) ◽  
pp. 1362-1367 ◽  
Author(s):  
Christian Rainer ◽  
Romed Meirer ◽  
Alexander Gardetto ◽  
Anton H. Schwabegger ◽  
Milomir M. Ninkovic
Keyword(s):  
Lower Extremity ◽  
Island Flap ◽  
Myocutaneous Flaps ◽  
Skin Island ◽  
Skin Island Flap

Mastoid Skin Island Flap: A Simple Technique for Conchal Defect Reconstruction

1993 ◽  
Vol 1 (3) ◽  
pp. 137-140
Author(s):  
O Antonyshyn
Keyword(s):  
Skin Graft ◽  
External Auditory Canal ◽  
Simple Technique ◽  
Island Flap ◽  
Defect Reconstruction ◽  
One Stage ◽  
Skin Island ◽  
One Stage Reconstruction ◽  
Graft Reconstruction ◽  
Skin Island Flap

O Antonyshyn. Mastoid skin island flap: A simple technique for conchal defect reconstruction. Can J Plast Surg 1993; 1(3): 137-140. Conchal defects resulting from tumour excision can pose a difficult reconstructive problem. These defects generally involve the entire concha and occasionally extend to the external auditory canal. Under these circumstances, skin graft reconstruction is unsuitable. A simple technique of conchal reconstruction using a mastoid skin island flap is described. The flap provides a reliable one-stage reconstruction of the concha and posterior conchal wall.

scholarly journals Keystone Design Perforator Island Flap for Closure of the Anterolateral Thigh Flap Donor Site: a Case Series and Our Experience

2021 ◽  
Author(s):  
Feiyu Cai ◽  
Yanshi Liu ◽  
Kai Liu ◽  
Jiasharete Jielile ◽  
Aihemaitijiang Yusufu
Keyword(s):  
Donor Site ◽  
Case Series ◽  
Island Flap ◽  
Anterolateral Thigh Flap ◽  
High Survival ◽  
Anterolateral Thigh ◽  
Mean Size ◽  
The Mean ◽  
Alt Flap

Abstract Purpose: With the development of microsurgical techniques, the anterolateral thigh (ALT) flap has been widely used in reconstruction of various soft-tissue defects. However, there were few studies focusing on the closure of the ALT flap donor site, especially when the width of the harvested ALT flap was more than 6 cm. The purpose of this study was to share our experience of using Keystone Design Perforator Island Flap (KDPIF) to repair the ALT flap donor site where can’t be closed without a skin graft.Method: A retrospective study was used to analyze 12 patients who underwent the reconstruction of the ALT flap donor site using KDPIF from February 2018 to December 2020. Demographics, flap characteristics, surgical technique, postoperative complications, Vancouver Scar Scale (VSS) score, and Scar Cosmesis Assessment and Rating (SCAR) score were statistically analyzed.Results: 12 patients (10 males, 2 females) with the mean age 47.5 years (range, 27-66 years) were included in this study. All ALT flap donor sites were closed by the KDPIF. The mean size of the harvested ALT flap (the donor site size) was 8.1 cm × 14.4 cm (range from 8.0 cm × 11.0 cm to 9.0 cm × 21.0 cm), and the mean size of keystone flap was 9.1 cm × 16.4 cm (range from 8.0 cm × 13.0 cm to 12.0 cm × 19.0 cm). At the mean follow-up of 8.3 months (range, 6-12 months), two patients suffered from the skin infection around the flap, which was controlled under the treatment of wound dressing change and oral antibiotics. Wound dehiscence, osteofascial compartment syndrome (OCS), venous return disorder, and skin necrosis were not presented in any patients. All patients were evaluated at the final follow-up with ASS core (mean, 6.7; range, 5-8) and SCAR core (mean, 7.3; range, 6-9).Conclusion: This study demonstrated that the KDPIF that can be used to close the ALT flap donor site primarily is an effective and alternative treatment for patients with a the width of the donor site more than 6 cm including the advantages of high survival rate, low morbidity, good aesthetics, and simple operation.

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