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

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

Muscle versus Fasciocutaneous Flap in Lower Limb Reconstruction: Is There a Best Option?

2017 ◽  
Vol 33 (S 01) ◽  
pp. S27-S33 ◽  
Author(s):  
Martina Corno ◽  
Salvatore D'Arpa ◽  
Pietro Di Summa ◽  
Igor Pellegatta ◽  
Luigi Valdatta ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Lower Limb ◽  
Donor Site ◽  
Anterolateral Thigh Flap ◽  
Soft Tissue Defects ◽  
Perforator Flaps ◽  
Muscle Flaps ◽  
Limb Reconstruction ◽  
Lower Limb Reconstruction ◽  
Tissue Defects

AbstractSoft tissue defects of the lower extremity that expose underlying bones, joints, and tendons pose challenging problems and generally require free tissue transfer for a successful reconstruction. Historically, muscle flaps were the gold standard choice for lower limb reconstruction. To obviate the unpredictable appearance and high donor-site morbidity of muscle flaps, fasciocutaneous flaps were introduced. Recently, perforator flaps, such as the anterolateral thigh flap, gained a leading role in the reconstructive scenario. There is growing evidence in the literature supporting that fasciocutaneous and perforator flaps are comparable to muscle flaps in terms of flap survival, postoperative infection, osteomyelitis, bone union, and ambulation. With the advances of knowledge in perforator anatomy and their mapping, a new era of lower limb reconstruction has begun. Propeller flap could be raised on any suitable perforator vessel and, without the aid of microsurgical anastomosis, used to restore small- to middle-sized soft tissue defects. In this review, we intend to analyze pros and cons of muscle and fasciocutaneous free flaps and the applicability of the propeller flaps in lower limb reconstruction.

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 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.

Tear drop-free anterolateral thigh flap, a versatile design for lower limb reconstruction after trauma

Microsurgery ◽  
2017 ◽  
Vol 38 (3) ◽  
pp. 278-286 ◽  
Author(s):  
Sergio Razzano ◽  
Sami Ramadan ◽  
Andrea Figus ◽  
Richard M. Haywood
Keyword(s):  
Lower Limb ◽  
Anterolateral Thigh Flap ◽  
Limb Reconstruction ◽  
Anterolateral Thigh ◽  
Lower Limb Reconstruction

A New Recipient Artery for Reconstruction of Soft-Tissue Defects in the Lower Limb with a Free Anterolateral Thigh Flap

2012 ◽  
Vol 130 (5) ◽  
pp. 1059-1065 ◽  
Author(s):  
Shun-Hong Gao ◽  
Shi-Ming Feng ◽  
Chao Chen ◽  
Cheng Jiao ◽  
Lai-Qin Sun ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Lower Limb ◽  
Anterolateral Thigh Flap ◽  
Soft Tissue Defects ◽  
Recipient Artery ◽  
Anterolateral Thigh ◽  
Tissue Defects

Reconstruction of a full-thickness buccal defect with anterolateral thigh flap – case report

2018 ◽  
Vol 7 (2) ◽  
pp. 39-42
Author(s):  
Małgorzata Czesak ◽  
Daniel Majszyk ◽  
Ewa Osuch-Wójcikiewicz ◽  
Kazimierz Niemczyk
Keyword(s):  
Squamous Cell Carcinoma ◽  
Case Report ◽  
Tumor Resection ◽  
Free Flaps ◽  
Anterolateral Thigh Flap ◽  
Full Thickness ◽  
Simultaneous Reconstruction ◽  
Anterolateral Thigh ◽  
Alt Flap ◽  
Tissue Defects

Extensive tissue defects resulting from tumor resection within the head and neck require simultaneous reconstruction. One of the most commonly used free flaps in reconstruction oral cavity is the free anterolateral thigh flap. A case of a 57-year-old woman with squamous cell carcinoma of the cheek has been presented, in which the reconstruction of the full thickness of the cheek with a folded free anterolateral thigh flap has been performed. The authors provide treatment methods and the possibility of using ALT flap.

Free Flaps in Complex Lower Limb Reconstruction - 2-Year Experience

2014 ◽  
Vol 30 (S 01) ◽  
Author(s):  
Horácio Zenha ◽  
Carla Diogo ◽  
Sara Ramos ◽  
Susana Pinheiro ◽  
Ricardo Carvalho ◽  
...  
Keyword(s):  
Lower Limb ◽  
Free Flaps ◽  
Limb Reconstruction ◽  
Lower Limb Reconstruction

Reconstruction of Extensive Soft Tissue Defects of Lower Extremity With the Extended Anterolateral Thigh Flap

2021 ◽  
pp. 153473462098223
Author(s):  
Jong-Ho Kim ◽  
Hyokyung Yoo ◽  
Seokchan Eun
Keyword(s):  
Soft Tissue ◽  
Lower Extremity ◽  
Distal Portion ◽  
Outcome Data ◽  
Anterolateral Thigh Flap ◽  
Soft Tissue Defects ◽  
Flap Viability ◽  
Anterolateral Thigh ◽  
Large Skin ◽  
Tissue Defects

The anterolateral thigh flap is a classic flap used for various reconstruction defects. However, the flap viability of extended large skin paddles (ie, 240 cm2) was doubted by many surgeons. This study reports successful experience of reconstructing extensive soft tissue defects of lower extremity using extended large skin paddles. Twelve consecutive patients who had undergone reconstruction of defects using an extended anterolateral thigh flap were identified. Patient characteristics (age, sex, defect location, injured structures, and type of flap) and outcome data were analyzed retrospectively. One artery and 2 accompanying veins were anastomosed to vascularize each flap. Follow-up periods ranged from 10 to 91 months postoperatively. The average size of the flaps was 268.75 cm2 (range = 220-391 cm2). All flaps were perforator flaps with one perforator except that 2 perforators were used in 3 patients. Two patients suffered partial flap necrosis of the distal portion with delayed healing. In conclusion, the extended anterolateral thigh flap is a considerable option for massive defects requiring composite tissue coverage. This flap is advantageous for reconstructing various complex defects in the lower extremities, providing a pliable and vascularized tissue to cover exposed extensive defects including tendons, nerves, and bones.

Sign in / Sign up

Export Citation Format

Share Document