The Vascular Pedicle of the Anterolateral Thigh Flap as an Alternative Recipient Site for Thigh Free Flaps

2008 ◽  
Vol 24 (2) ◽  
pp. 131-136 ◽  
Author(s):  
Geoffrey Hallock
Keyword(s):  
Free Flaps ◽  
Anterolateral Thigh Flap ◽  
Vascular Pedicle ◽  
Recipient Site ◽  
Anterolateral Thigh

scholarly journals Pedicled anterolateral thigh flap for contralateral groin composite defect

2010 ◽  
Vol 43 (01) ◽  
pp. 103-105
Author(s):  
S. P. Bharath ◽  
G. Madhusudan ◽  
Suraj Manjunath
Keyword(s):  
Free Flaps ◽  
Anterior Superior Iliac Spine ◽  
Anterolateral Thigh Flap ◽  
Wide Resection ◽  
Vascular Pedicle ◽  
Anterolateral Thigh ◽  
Vascular Compromise ◽  
Femoral Vessels ◽  
Alt Flap ◽  
Composite Defect

ABSTRACTPedicled anterolateral thigh flap has been well described for ipsilateral groin defects. Its versatility depends on the intact femoral vessels. When the external iliac and the femoral vessels are absent, especially secondary to wide surgical tumour ablations in the groin region, ipsilateral ALT flap is not an option. Free flaps also are difficult because of lack of recipient vessels. We report a case of composite groin defect following wide resection of recurrent liposarcoma along with encased vessels which was covered with a pedicled anterolateral thigh flap from the opposite thigh. The technique of lengthening the vascular pedicle and medializing the pedicle, to effectively increase its reach to the contralateral anterior superior iliac spine without vascular compromise, is described.

The anterolateral thigh flap; variations in its vascular pedicle

1989 ◽  
Vol 42 (3) ◽  
pp. 260-262 ◽  
Author(s):  
Isao Koshima ◽  
Hiroshi Fukuda ◽  
Ryuiti Utunomiya ◽  
Shugo Soeda
Keyword(s):  
Anterolateral Thigh Flap ◽  
Vascular Pedicle ◽  
Anterolateral Thigh

scholarly journals Revisited Anterolateral Thigh Free Flaps For Reconstructive Microsurgery : One Year Evaluation

1970 ◽  
Vol 1 (2) ◽  
Author(s):  
Parintosa Atmodiwirjo ◽  
Siti Handayani ◽  
Shelly Madona Djaprie
Keyword(s):  
Soft Tissue ◽  
Free Flaps ◽  
Soft Tissue Defect ◽  
Anterolateral Thigh Flap ◽  
Soft Tissue Defects ◽  
Anterolateral Thigh ◽  
Wide Range ◽  
Reconstructive Microsurgery ◽  
One Year ◽  
Tissue Defects

Extensive soft tissue defects present a dif!cult problem to the plastic surgeon as they are usually associated with exposed important structures such as vessels, nerves, tendons, joint cavity or bone. Reconstruction of soft tissue defects have a wide range of therapeutic options. We reconstructed soft tissue defect in many areas using free anterolateral thigh flap (ALTF). From Februari 2009 - 2010, 9 cases of soft tissue defects in the face, neck, leg and foot of various etiologic factors were admitted to the plastic and reconstructive surgery unit, Cipto Mangunkusumo general hospital. Trauma is the commonest cause of soft tissue defects of the lower extremity, followed by tumours. The cruris was the commonest site (4 cases, 44,4%). Flap success rate was 66,67 %. Failure was reported 1 cases in this study due to vein compromise. In our hospital, we are quite familiar with Anterolateral thigh flap (ALTF) even though the case is limited. Anterolateral thigh flap (ALTF) is used for reconstruction of various simple and complex soft tissue defects, for big and small defects with cavity (orbita).

scholarly journals Aesthetic and Functional Outcomes of the Innervated and Thinned Anterolateral Thigh Flap in Reconstruction of Upper Limb Defects

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Carlos Alberto Torres-Ortíz Zermeño ◽  
Javier López Mendoza
Keyword(s):  
Upper Extremity ◽  
Free Flaps ◽  
Sensory Function ◽  
Anterolateral Thigh Flap ◽  
Level Of Evidence ◽  
Average Percentage ◽  
Aesthetic Result ◽  
Anterolateral Thigh ◽  
Good Cosmetic ◽  
Alt Flap

Background. The anterolateral thigh (ALT) flap has been widely described in reconstruction of the upper extremity. However, some details require refinement to improve both functional and aesthetic results. Methods. After reconstruction of upper extremity defects using thinned and innervated ALT flaps, functional and aesthetic outcomes were evaluated with the QuickDASH scale and a Likert scale for aesthetic assessment of free flaps, respectively. Results. Seven patients with a mean follow-up of 11.57 months and average flap thickness of 5 mm underwent innervation by an end-to-end neurorrhaphy. The average percentage of disability (QuickDASH) was 21.88% with tenderness, pain, temperature, and two-point discrimination present in 100% of cases, and the aesthetic result gave an overall result of 15.40 (good) with the best scores in color and texture. Conclusions. Simultaneous thinning and innervation of the ALT flap lead to a good cosmetic result and functional outcome with a low percentage of disability, which could result in minor surgical procedures and better recovery of motor and sensory function. Level of Evidence. IV.

scholarly journals Reconstruction of Complex Soft-Tissue Defects in Buttock Using The Proximally Based Anterolateral Thigh Flap: An Alternative Algorithm

2021 ◽  
Author(s):  
Danying Wang ◽  
Mengqing Zang ◽  
Shan Zhu ◽  
Bo Chen ◽  
Shanshan Li ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Free Flaps ◽  
Melanocytic Nevus ◽  
Anterolateral Thigh Flap ◽  
Soft Tissue Defects ◽  
Defect Reconstruction ◽  
Reconstruction Methods ◽  
Circumflex Femoral Artery ◽  
Anterolateral Thigh ◽  
Tissue Defects

Abstract Background Local and free flaps are most widely used in buttock reconstruction. However, local flaps and free flaps may not be appropriate for all complex soft tissue defects in buttock. In this study, we propose an alternative approach for buttock reconstruction and provide preliminary assessment in clinical efficacy of using a proximally based anterolateral thigh flap for buttock reconstruction. Methods In this study, we retrospectively analyzed the data of the patients with medium- to large-sized defects of buttock. All patients underwent buttock defect reconstruction using a proximally based anterolateral thigh flap between August 2012 and December 2020. Results Eight pedicled anterolateral thigh flaps were used to reconstruct buttock defects after tumor ablation in six patients, scar revision in one patient, melanocytic nevus resection in one patient. Flap size ranged from 25 × 8 cm to 30 × 12 cm, with pedicle length ranging from 12 to 20 cm. Flaps were elevated based on the distal musculocutaneous perforators from the descending branch of the lateral circumflex femoral artery and completely survived without any perfusion-related complications. We achieved satisfactory results from both the functional and aesthetic point-of-view at the 6-month follow-up in all cases. Conclusions The proximally based anterolateral thigh flap can be a valuable reconstructive option with sufficient tissue and a long vascular pedicle for buttock defect reconstruction.

scholarly journals Experiência de um hospital de referência com o retalho livre anterolateral da coxa na reconstrução de extremidades

2020 ◽  
Vol 9 (1) ◽  
Author(s):  
Nikolas Higa Benites ◽  
Guilherme Leipner Margatho ◽  
Fernanda Ruiz de Andrade ◽  
Luis Guilherme Rosifini Alves Rezende ◽  
Amanda Favaro Cagnolati ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Free Flap ◽  
Donor Site ◽  
Free Flaps ◽  
Donor Site Morbidity ◽  
Anterolateral Thigh Flap ◽  
Soft Tissue Reconstruction ◽  
Anterolateral Thigh ◽  
Anterolateral Thigh Flaps ◽  
The Impact

Introdução: Com a evolução da microcirurgia ao longo dos anos o Retalho Anterolateral da Coxa vem se tornando uma das principais opções para reconstruções na cabeça, pescoço, tronco e extremidades devido sua versatilidade e confiabilidade. Objetivo: Descrever dados de um hospital terciário referência em trauma na reconstrução de extremidades com o Retalho Anterolateral da Coxa. Método: Este é um estudo retrospectivo de 18 retalhos Anterolateral da Coxa microcirúrgicos realizados entre Março de 2016 e Outubro de 2019 em pacientes de todas as idades, na reconstrução de membros, onde se observou dados referentes ao paciente: idade, sexo, membro acometido, tempo entre a lesão e a confecção do retalho; ao intraoperatório: anatomia dos vasos perfurantes, tempo cirúrgico total, vasos receptores utilizados; e informações do pós-operatório: número de cirurgias relacionadas ao retalho, necessidade de reabordagem e número de perdas. Foram excluídos pacientes que perderam seguimento ou que apresentaram dados do prontuário incompletos. Realizou-se estatística descritiva e cruzamento de algumas variáveis utilizando o teste t-Student. Resultados: Nas reconstruções houve predomínio de pacientes do sexo masculino (72%), em idade produtiva, de etiologia traumática e nos membros inferiores. O tempo médio até a reconstrução foi de 21 dias e o tempo cirúrgico foi de 384 minutos. O paciente permaneceu, em média, 39 dias internado. Dos 18 retalhos, 3 evoluíram com necrose, 2 por trombose arterial e 1 por infecção. 6 retalhos necessitaram de reaborgadem de emergência, 3 por sangramento, 2 por congestão e 1 por infecção. Foram realizadas uma média de 3 cirurgias até a alta. Foram identificadas 15 perfurantes miocutâneas (83%) e 3 septocutâneas (17%). A análise do sucesso do retalho em relação ao tempo cirúrgico e dos dias até a cirurgia não mostrou significância estatística, assim como a necessidade de reabordagem em relação ao tempo cirúrgico. Conclusão: O retalho Anterolateral da Coxa mostrou-se confiável, além de apresentar diversas vantagens como: por ser retirado com uma grande ilha de pele, apresentar pedículo longo, vasos de bom calibre, não necessitar de mudança de decúbito e apresentar baixa morbidade da área doadora.Descritores: Retalho Miocutâneo; Microcirurgia; Hospitais Especializados.ReferênciasDaniel RK, Taylor GI. Distant transfer of an island flap by microvascular anastomoses. A clinical technique. Plast Reconstr Surg. 1973;52(2):111-17.Ninkovic M, Voigt S, Dornseifer U, Lorenz S, Ninkovic M. Microsurgical advances in extremity salvage. Clin Plast Surg. 2012;39(4):491-505.Tamimy MS, Rashid M, Ehtesham-ul-Haq, Aman S, Aslam A, Ahmed RS. Has the anterolateral thigh flap replaced the latissimus dorsi flap as the workhorse for lower limb reconstructions? J Pak Med Assoc. 2010; 60(2):76-81.Spyropoulou A, Jeng SF. Microsurgical coverage reconstruction in upper and lower extremities. Semin Plast Surg. 2010;24(1):34-42.Xiong L, Gazyakan E, Kremer T, Hernekamp FJ, Harhaus L, Saint-Cyr M et al. Free flaps for reconstruction of soft tissue defects in lower extremity: a meta-analysis on microsurgical outcome and safety. Microsurgery. 2016; 36(6):511-24.Song YG, Chen GZ, Song YL. The free thigh flap: a new free flap concepted based on the septocutaneous artery. Br J Plast Surg. 1984; 37(2):149-59.Wei FC, Jain V, Celik N, Chen HC, Chuang DC, Lin CH. Have we found an ideal soft-tissue flap? An experience with 672 anterolateral thigh flaps. Plast Reconstr Surg. 2002;109(7):2219-26Kimata Y, Uchiyama K, Ebihara S, Nakatsuka T, Harii K. Anatomic variation and technical problems of the anterolateral thigh flap: A report of 74 cases. Plast Reconstr Surg. 1998; 102(5):1517-23Spindler N, Al-Benna S, Ring A, Homann H, Steinsträsser L, Steinau HU et al. Free anterolateral thigh flaps for upper extremity soft tissue reconstruction. GMS Interdiscip Plast Reconstr Surg DGPW. 2015;4:Doc05.Kimura N, Satoh K, Hasumi T, Ostuka T. Clinical application of the free thin anterolateral thigh flap in 31 consecutive patients. Plast Reconstr Surg. 2001;108(5):1197-210.Collins J, Ayeni O, Thoma A. A systematic review of anterolateral thigh flap donor site morbidity. Can J Plast Surg. 2012;20(1):17-23.Kuo YR, Jeng SF, Kuo MH, Huang MN, Liu YT, Chiang YC et al. Free anterolateral thigh flap for extremity reconstruction: Clinical experience and functional assessment of donor site. Plast Reconstr Surg. 2001;107(7):1766-71Novak CB, Lipa JE, Noria S, Allison K, Neligan PC, Gilbert RW. Comparison of anterolateral thigh and radial forearm free flap donor site morbidity. Microsurgery. 2007;27(8):651-54.Pagano M, Gauvreau K. Princípios de Bioestatística. São Paulo: Pioneira Thomson Learning; 2004.SAS Institute Inc., SAS/STAT® User’s Guide. Version 9.4. Cary, NC: SAS Institute Inc.Arruda LRP, Silva MAC, Malerba FG, Turíbio FM, Fernandes MC, Matsumoto MH. Fraturas expostas: estudo epidemiológico e prospectivo. Acta ortop bras. 2009;17(6):326-30.Cunha FM, Braga GF, Drumond Jr SN, Figueiredo CTO. Epidemiologia de 1.212 fraturas expostas. Rev Bras Ortop. 1998;33(6):451-56.Court-Brown CM, Rimmer S, Prakash U, McQueen MM. The epidemiology of open long bone fractures. Injury. 1998;29(7):529-34.Shabtai M, Rosin D, Zmora O, Munz Y, Scarlat A, Shabtai EL et al. The impact of a resident’s seniority on operative time and length of hospital stay for laparoscopic appendectomy: outcomes used to measure the resident’s laparoscopic skills. Surg Endosc. 2004;18(9):1328-30.Godina M. Early microsurgical reconstruction of complex trauma of the extremities. Plast Reconstr Surg.1986;78:285-292Smit JM, Acosta R, Zeebregts CJ, Liss AG, Anniko M, Hartman EH. Early reintervention of compromised free flaps improves success rate. Microsurgery. 2007;27(7):612-16.

ANTEROLATERAL THIGH FLAP IN LOWER LIMB RECONSTRUCTION

2019 ◽  
pp. 44-48
Author(s):  
Hong Phuc Le ◽  
Thiet Son Tran ◽  
Nghi Thanh Nhan Le
Keyword(s):  
Lower Limb ◽  
Free Flaps ◽  
Anterolateral Thigh Flap ◽  
Soft Tissue Defects ◽  
Fasciocutaneous Flaps ◽  
Limb Reconstruction ◽  
Anterolateral Thigh ◽  
Lower Limb Reconstruction ◽  
Alt Flap ◽  
Tissue Defects

Introduction: Anterolateral thigh flap is one of the most researched and widely used perforator flaps in the recent decades in plastic surgery as a whole and in limb reconstruction, especially in cases with complex deflects, in particular. This report aimed to evaluate anterolateral thigh flap in reconstruction of complex lower limb soft tissue defects. Subjects and methods: From August 2014 to August 2015, at Hue University of Medicine and Pharmacy Hospital, 12 cases with complex soft tissue defects in lower limb were reconstructed and covered with ALT flaps: two distal based pedicle ALT flaps for popliteal and around knee joint defects and 10 composite ALT free flaps for lower leg reconstruction. Results: Twelve flaps used included: two peripheral pedicled fasciocutaneous flaps, ten complex free flaps (01 complex myo-fasciocutaneous flap providing muscle for deep space filled, fascial for tendon reconstruction and surface covering of the defect; 05 vastus lareralis myocutaneous flaps providing muscle for dead space filling and covering; 04 fasciocutaneous flaps involving the fascia lata for fascial reconstruction and covering). The size of flaps ranged from 8 to 27cm in length and from 6 to 13cm in width. The largest flap was 240cm2,the smallest was 50cm2. All 12 flaps survived. Short-term results at one month after surgery were consideredas good in eleven patients and fair in one patient. There were no special complications at donor sites. Paresthesia at the donor site was noted in two cases. Conclusion: ALT flap with its versatility as peripheral pedicled flap or free flap can be used in lower limb reconstruction with high success rate of 100% (12/12). Preoperative skin perforator mapping by Doppler was highly accurate (12/12) compared with intraoperative findings. Complex free ALT flap is suitable for reconstruction of major defects involving different type of tissue in lower limb with satisfied results. Key words: Anterolateral thigh flap, limb, ower limb

Sign in / Sign up

Export Citation Format

Share Document