Elwakeel, H. (2021). Assessment of Free Anterolateral Thigh Flap for Extremity Reconstruction. The Egyptian Journal of Plastic and Reconstructive Surgery, 45(4), 239-246. doi: 10.21608/ejprs.2021.201635
Helmy Elwakeel. "Assessment of Free Anterolateral Thigh Flap for Extremity Reconstruction". The Egyptian Journal of Plastic and Reconstructive Surgery, 45, 4, 2021, 239-246. doi: 10.21608/ejprs.2021.201635
Elwakeel, H. (2021). 'Assessment of Free Anterolateral Thigh Flap for Extremity Reconstruction', The Egyptian Journal of Plastic and Reconstructive Surgery, 45(4), pp. 239-246. doi: 10.21608/ejprs.2021.201635
Elwakeel, H. Assessment of Free Anterolateral Thigh Flap for Extremity Reconstruction. The Egyptian Journal of Plastic and Reconstructive Surgery, 2021; 45(4): 239-246. doi: 10.21608/ejprs.2021.201635
Assessment of Free Anterolateral Thigh Flap for Extremity Reconstruction
The Department of Plastic Surgery, Faculty of Medicine, Alexandria University, Egypt
Abstract
Background: Free tissue transfer has undergone substantial improvement over the past three decades, focusing on functional and aesthetic results of reconstruction for both the donor and recipient sites. The free ALT flap is atypical example of this revolution from its early description by Song et al., in 1984 and its later popularization and wide use to reconstruct defects all over the body from the head to toes yielding very good functional and aesthetic results with relatively minimal donor site morbidity making it a workhorse free flap. For limb reconstruction, it provides a good size of many tissue types including skin, subcutaneous fat, muscle, and fascia with possible sensate flap and flow-through flap for limb revascularization. The flap pedicle is of adequate size and length, 2 team approach is possible, and donor site morbidity is minimal especially with direct closure. Patients and Methods: From April 2016 – December 2018, 11 male patients aged 5-41 years (mean 27.5 years) with extremity defects including 6 upper limbs and 5 lower limbs defects were reconstructed using free ALT flap. Defects were caused by RTA (8 cases), electrical burn (1 case), and release of contractures (2 cases). Results: All flaps survived completely except one case suffered slowly progressive congestion ending in partial flap < br />loss, managed by debridement and skin grafting. Except for one flap harvested as musculocutaneous, all flaps were fasciocutaneous. Flaps perforator pattern were musculocutaneous in 81.9% of cases and septocutaneous in 18.1% of cases. 9 flaps were based on a single perforator, 2 and 3 perforators each vascularized one flap. Conclusion: Free ALT flap is a reliable, versatile reconstructive option for small to moderately large limb defects. Donor site morbidity is minimal with direct closure.
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