Versatility of antero-lateral thigh free flap in reconstruction of defects in different parts of our body- our experience
Keywords:
ALT Flap, soft tissue defects, reconstructionAbstract
Introduction Extensive soft tissue defects pose a great deal of challenge to the reconstructive surgeon.The aim of this study is to analyse the outcome of free anterolateral thigh(ALT) flaps for soft tissue reconstruction of defects following tumor excision,trauma and post burn. Methods : A retrospective review of 19 patients undergoing ALT Flaps for various reasons from Dec 2018 to Jan 2021 was performed to determine perioperative factors, demographic profile , complications and outcomes. Results : The mean age the study population was 47.2 years. The male to female ratio was 2.16:1 (68.5 % male, 31.5% females). The etiology of soft tissue defect was post- tumor resection – 47.36%, truam-36.8%, post burn reconstruction- 10.5% . The defect sites were most commonly leg-31.5%, upper extremity- 26.3%, buccal mucosa- 15.7%, scalp-10.5%, tongue- 10.5%,breast- 5.2%.Flaps were harvested from right thigh in 52% of cases and left thigh in 58% of the cases. Donor site was closed primarily in 11 cases (57.8%), SSG coverage was done for 8 cases ( 42.8%). The minimum operating time was 205 minutes and maximum was 435 minutes, with an average time of …………..The minimum hospital stay post op was 12 days , maximum being 45 days.
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Demirkan F, Chen HC, Wei FC, et al. The versatile anterolateral thigh flap: a musculocutaneous flap in disguise in head and neck reconstruction. Br J Plast Surg 2000;53:30– 36
Jeng SF, Kuo YR, Wei FC, Su CY, Chien CY. Reconstruction of extensive composite mandibular defects with large lip involvement by using double free flaps and fascia lata grafts for oral sphincters. Plast Reconstr Surg 2005;115:1830–1836
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: 2219–2226
Wei FC, Celik N, Chen HC, Cheng MH, Huang WC. Combined anterolateral thigh flap and vascularized fibula osteoseptocutaneous flap in reconstruction of extensive composite mandibular defects. Plast Reconstr Surg 2002;109: 45–52
Elliott RM, Weinstein GS, Low DW, Wu LC. Reconstruction of complex total parotidectomy defects using the free anterolateral thigh flap: a classification system and algorithm. Ann Plast Surg 2011;66(5):429–437 7
Yu P, Sanger JR, Matloub HS, Gosain A, Larson D. Anterolateral thigh fasciocutaneous island flaps in perineoscrotal reconstruction. Plast Reconstr Surg 2002;109(2):610–616, discussion 617– 618
Song YG, Chen GZ, Song YL. The free thigh flap: a new free flap concept based on the septocutaneous artery. Br J Plast Surg 1984;37:149–159
Ao M, Uno K, Maeta M, Nakagawa F, Saito R, Nagase Y. De-epithelialised anterior (anterolateral and anteromedial) thigh flaps for dead space filling and contour correction in head and neck reconstruction. Br J Plast Surg 1999;52:261– 267
Xu DC, Zhong SZ, Kong JM, et al. Applied anatomy of the anterolateral femoral flap. Plast Reconstr Surg 1988;82:305– 310
Mardini S, Tsai FC, Wei FC. The thigh as a model for free style free flaps. Clin Plast Surg 2003;30:473–480
Wei FC, Silverman RT, Hsu WM. Retrograde dissection of the vascular pedicle in toe harvest. Plast Reconstr Surg 1995;96:1211–1214
Song YG, Chen GZ, Song YL. The free thigh flap: a new free flap concept based on the septocutaneous artery. Br J Plast Surg. 1984 Apr;37(2):149-59. DOI: 10.1016/0007- 1226(84)90002- X
Yang JY, Tsai FC, Chana JS, Chuang SS, Chang SY, Huang WC. Use of free thin anterolateral thigh flaps combined with cervicoplasty for reconstruction of postburn anterior cervical contractures. Plast Reconstr Surg. 2002 Jul;110(1):39-46. DOI: 10.1097/00006534-200207000-00009
Chen HC, Tang YB. Anterolateral thigh flap: an ideal soft tissue flap. Clin Plast Surg. 2003 Jul;30(3):383-401. DOI: 10.1016/S0094-1298(03)00040-3
Rajacic N, Gang RK, Krishnan J, Lal Bang R. Thin anterolateral thigh free flap. Ann Plast Surg. 2002 Mar;48(3):252-7. DOI: 10.1097/00000637-200203000-00004
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 Jun;109(7):2219-26; discussion 2227-30. DOI: 10.1097/00006534-200206000-00007
Zayakova Y, Stanev A, Mihailov H, et al. Application of local axial flaps to scalp reconstruction. Arch Plast Surg 2013;40:564–569
Hierner R, van Loon J, Goffin J, et al. Free latissimus dorsi flap transfer for subtotal scalp and cranium defect reconstruction: report of 7 cases. Microsurgery 2007;27:425– 428
Kuo YR, Seng-Feng J, Kuo FM, Liu YT, Lai PW. Versatility of the free anterolateral thigh flap for reconstruction of softtissue defects: review of 140 cases. Ann Plast Surg 2002;48: 161–166
Zhou G, Qiao Q, Chen GY, Ling YC, Swift R. Clinical experience and surgical anatomy of 32 free anterolateral thigh flap transplantations. Br J Plast Surg 1991;44:91–96
Chen HC, Tang YB. Anterolateral thigh flap: an ideal soft tissue flap. Clin Plast Surg 2003;30:383–401
Shieh SJ, Chiu HY, Yu JC, Pan SC, Tsai ST, Shen CL. Free anterolateral thigh flap for reconstruction of head and neck defects following cancer ablation. Plast Reconstr Surg 2000;105:2349–2357
Ensat F, Babl M, Conz C, Fichtl B, Herzog G, Spies M. DopplerSonografie und Farbdopplersonografie zur präoperativen Perforatordarstellung beim anterolateralen Oberschenkellappen [Doppler sonography and colour Doppler sonography in the preoperative assessment of anterolateral thigh flap perforators]. Handchir Mikrochir Plast Chir. 2011 Apr;43(2):71-5. DOI: 10.1055/s-0030-1255071
Wei FC, Celik N,Jeng SF. Application of “simplified nomenclature for compound flaps” to the anterolateral thigh flap. Plast Reconstr Surg. 2005 Apr;115(4):1051-5; discussion 1056-7. DOI: 10.1097/01.PRS.0000156296.74066.80
Langer S, Steinsträsser L, Lehnhardt M, Strack N, Steinau HU, Daigeler A, Homann HH. Der freie ALT-Oberschenkellappen in der traumatologischen und onkologischen Defektdeckung [Anterolateral thigh flaps for reconstruction of traumatological and oncological defects]. Unfallchirurg. 2008 May;111(5):323- 30. DOI: 10.1007/s00113-007- 1355-y
Jia-Ao Y, Hong-Jing L, Zheng-Hua J, et al. Reconstruction of a large pediatric scalp defect with skull exposure by a free anterolateral thigh flap. Plast Reconstr Surg 2012;129:178e–180e
O’Connell DA, Teng MS, Mendez E, et al. Microvascular free tissue transfer in the reconstruction of scalp and lateral temporal bone defects. Craniomaxillofac Trauma Reconstr 2011;4:179–188
Fischer JP, Sieber B, Nelson JA, et al. A 15-year experience of complex scalp reconstruction using free tissue transfer-analysis of risk factors for complications. Reconstr Microsurg 2013;29:89–97
Ozkan O, Coskunfirat OK, Ozgentas HE, et al. Rationale for reconstruction of large scalp defects using the anterolateral thigh flap: structural and aesthetic outcomes. J Reconstr Microsurg 2005;21:539–545
Joo YH, Cho KJ, Park JO, et al. Usefulness of the anterolateral thigh flap with vascularized fascia lata for reconstruction of orbital floor and nasal surface after total maxillectomy. Laryngoscope 2013;123:2125–2130
Hanasono MM, Sacks JM, Goel N, et al. The anterolateral thigh free flap for skull base reconstruction. Otolaryngol Head Neck Surg 2009;140:855–860
Kimura N, Satoh K. Consideration of a thin flap as an entity and clinical applications of the thin anterolateral thigh flap. Plast Reconstr Surg 1996;97:985–992
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