The Versatility of the Free Anterolateral Thigh Flap in Reconstruction of Soft Tissue Defects in the Extremities

Document Type : Original Article

Authors

The Department of Plastic and Reconstructive Surgery, Faculty of Medicine, Alexandria University

Abstract

Background: Soft tissue defects in the upper and lower
extremities pose difficult reconstructive challenges. The free
anterolateral thigh (ALT) flap is among the different options
that can be used to reconstruct these defects. This flap is
characterized by a long pedicle with relative ease of dissection.
Patients and Methods: Fourteen patients suffering from
upper and lower extremities defects due to different reasons
were reconstructed using the anterolateral thigh (ALT) flap.
Results: Superficial necrosis occurred in one case and
hematoma in another. Otherwise, all flaps survived well.
Conclusion: The ALT flap can be considered an excellent
and ideal alternative for reconstruction of complex defects in
the upper and lower extremities.

Main Subjects


1- Zheng X., Zheng C., Wang B., Qiu Y., Zhang Z., Li H.
and Wang X.: Reconstruction of complex soft-tissue
defects in the extremities wiith chimeric anterolateral
thigh perforator flap. Int. J. Surg., 26: pp 25-31, 2016.
2- Paro J., Chiou G. and Sen S.K.: Comparing muscle and
fasciocutaneous free flaps in lower extremity reconstruction-
does it matter? Ann. Plast. Surg., Vol. (Suppl. 3) 76:
pp. S213-15, 2016.
3- Sofiadellis F., Liu D.S., Webb A., Macgill K., Rozen W.M.
and Ashton M.W.: Fasciocutaneous free flaps are more
reliable than muscle free flaps in lower limb trauma
reconstruction: Experience in a single trauma center. J.
Reconstr. Microsurg., Vol. 28 (5): pp. 333-40, 2012.
4- Kim S.W., Youn S., Kim J.D., Kim J.T., Hwang K.T. and
Kim Y.H.: Reconstruction of extensive lower limb defects
with thoracodorsal axis chimeric flaps. Plast. Reconstr.
Surg., Vol. 132 (2): pp. 470-9, 2013.
5- Song Y.G., Chen G.Z. and Song Y.L.: The free thigh flap:
A new free flap concept based on the septocutaneous
artery. Br. J. Plast. Surg., Vol. 37 (2): pp. 149-59, 1984.
6- Gong Z.J., Wang K., Tan H.Y., Zhang S., He Z.J. and Wu
H.J.: Application of thinned anterolateral thigh flap for
the reconstruction of head and neck defects. J. Oral
Maxillofac. Surg. Vol. 73 (7): pp. 1410-9, 2015.
7- Parmar S., Al-Asaadi Z., Martin T., Jennings C. and Pracy
P.: The anterolateral fasciocutaneous thigh flap for circumferential
pharyngeal defects can it really replace the
jejunum? Br. J. Oral Maxillofac. Surg., Vol. 52 (3): pp.
247-50, 2014.
8- Soltanian H., Garcia R.M. and Hollenbeck S.T.: Current
concepts in lower extremity reconstruction. Plast. Reconstr.
Surg., Vol. 136 (6): pp. 815e-29e, 2015.
9- Kolbenschlag J., Klinkenberg M., Hellmich S., Germann
G. and Megerle K.: Impact of timing of admission and
microvascular reconstruction on free flap success rates
in traumatic upper extremity defects. J. Reconstr. Microsurg.,
Vol. 31 (6): pp. 414-9, 2015.
10- Fischer J.P., Wink J.D., Nelson J.A., Cleveland E., Grover
R., Wu L.C., et al.: A retrospective review of outcomes
and flap selection in free tissue transfers for complex
lower extremity reconstruction. J. Reconstr. Microsurg.,
Vol. 29 (6): pp. 407-6, 2013.
11- Kars¸ıdag˘ S., Akc¸al A., Turgut G., Ug˘urlu K. and Bas¸ L.:
Lower extremity soft tissue reconstruction with free flap
based on subscapular artery. Acta. Orthop. Traumatol.
Turc., Vol. 45 (2): pp. 100-8, 2011.
12- Xing-Quan Z., Shao-Dong W., Qing-Yu F. and Bao-An
M.: Versatility of rectus abdominis free flap for reconstruction
of soft-tissue defects in extremities. Microsurgery,
Vol. 24 (2): pp. 128-33, 2004.
13- Khan M.A., Jose R.M., Taylor C., Ahmed W. and Prinsloo
D.: Free radial forearm fasiocutaneous flap in the treatment
of distal third tibial osteomyelitis. Ann. Plast. Surg., Vol.
68 (1): pp. 58-61, 2012