Application of anterolateral thigh free flap to reconstruct head and neck soft 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.

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Computed tomography angiography-aided individualized anterolateral thigh flap design in the reconstruction of oral and maxillofacial soft tissue defects

Oral Surgery Oral Medicine Oral Pathology and Oral Radiology ◽

10.1016/j.oooo.2021.12.130 ◽

2021 ◽

Author(s):

Pengcheng Rao ◽

Shihong Luo ◽

Lei Wang ◽

Yong Li ◽

Guangxin Fu ◽

...

Keyword(s):

Computed Tomography ◽

Soft Tissue ◽

Computed Tomography Angiography ◽

Anterolateral Thigh Flap ◽

Soft Tissue Defects ◽

Anterolateral Thigh ◽

Flap Design ◽

Tissue Defects

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Results of Microvascular Free Flap for Reconstruction of Soft Tissue Defects: Our Early Experience

Bangladesh Journal of Plastic Surgery ◽

10.3329/bdjps.v3i2.18242 ◽

2014 ◽

Vol 3 (2) ◽

pp. 33-37

Author(s):

Debashis Biswas ◽

Md Abul Kalam ◽

Tanveer Ahmed ◽

Md Rabiul Karim Khan

Keyword(s):

Soft Tissue ◽

Free Flap ◽

Free Flaps ◽

Soft Tissue Defect ◽

Soft Tissue Defects ◽

Tissue Defect ◽

Radial Forearm ◽

After Cancer ◽

Microvascular Free Flap ◽

Tissue Defects

Extensive soft tissue defects following trauma, burn or after cancer surgery need coverage by flaps. Sometimes surrounding tissues are not healthy enough or quantity is not favorable to provide adequate pedicle flaps. Microvascular free flap can provide healthy tissue of adequate amount from distant area for those difficult situations.15 microvascular free flaps were performed from October 2011 to February 2013. Radial forearm free flap was done in 8 and Latissimusdorsi (LD) flap in 7 cases. 10 flaps done in foot, ankle & lower leg region (radial forearm-5, LD-5) and 5 flaps were done in face and scalp region (radial forearm-4, LD-1).12 flaps healed uneventfully with good coverage of the defect. Average ischemia time was 135 min (range 100-240 min) and average anastomosis time was 75 min (average 60-100 min). 2 flaps failed. There was necrosis of the tip of 2 LD and cumbersome swelling of the flap was found in 2 cases of LD flaps.Large soft tissue defect of body where local or regional flaps are not feasible; can be easily covered with free flaps. Its capacity to cover huge soft tissue defect has neutralizes its technical demand. Though complications are still high in our hands; can be reduced performing more number of cases. DOI: http://dx.doi.org/10.3329/bdjps.v3i2.18242 Bangladesh Journal of Plastic Surgery July 2012, 3(2): 33-37

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

Jurnal Plastik Rekonstruksi ◽

10.14228/jpr.v1i2.44 ◽

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).

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