Comparison between Free Anterolateral Thigh Flap and Free Medial sural Artery Perforator Flap in Reconstruction of Posttraumatic Soft Tissue Defects of Dorsum of the Foot

Abo Elhassan, Waleed; AbulElezz, Tarek A.; Ali, Amr E.; Elsayed, Gamal Y.

doi:10.21608/ejprs.2022.220426

Comparison between Free Anterolateral Thigh Flap and Free Medial sural Artery Perforator Flap in Reconstruction of Posttraumatic Soft Tissue Defects of Dorsum of the Foot

Document Type : Original Article

Authors

¹ The Department of Plastic & Reconstructive Surgery*, Faculty of Medicine, Sohag University ,

² The Department of Plastic & Reconstructive Surgery, Faculty of Medicine, Sohag University

³ The Department of Hand & Reconstructive Microsurgery Unit, Assiut University Hospital

⁴ The Department of Plastic & Reconstructive Surgery, Faculty of Medicine, Sohag

10.21608/ejprs.2022.220426

Abstract

Background: The objective of this study is to compare
between the free anterolateral thigh flap and free medial sural
artery perforator flap in reconstruction of post traumatic soft
tissue defects of dorsum of the foot as regard the function,
the aesthetic outcome, the complications and the patient
satisfaction.
Patients and Method: The study was conducted on 40
patients with post traumatic soft tissue defects of the dorsum
of the foot between August 2018 and August 2019. Patients
were allocated randomly into two groups. In group 1 (20
patients), the defect was reconstructed with free anterolateral
thigh perforator flap. In group 2 (20 patients), reconstruction
was done by free medial sural artery perforator flap.
Result: In group 1 (ALT flap), Complete flap survival
was achieved in all cases. Thirteen patients required secondary
debulking procedures and scar revisions.
In group 2 (MSAP Flap), Complete flap survival was
achieved in 17 cases with one flap totally lost and two flaps
had distal necrosis. One patient needed scar revision and
another patient needed flap advancement.
Conclusion: MSAP flap is good alternative in soft tissue
reconstruction of the dorsum of the foot. It has many advantages:
It is thin, pliable, fitted to normal footwear, less hairy
and there is no need for secondary procedures in most cases.
ALT flap is better than MSAP flap in larger defects coverage
but may need secondary debulking procedures or primary
thinning at the time of reconstruction.

Keywords

Main Subjects

Lower extremity and foot

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