ALT Flap Single-Stage Donor Site Closure with Loco-Regional Flaps: A Systematic Review

Abstract

The anterolateral thigh (ALT) flap is currently the main choice as a free flap for head and neck reconstruction, including intraoral and facial defects and it is gaining popularity in abdominal, orthopedic and pelvis reconstruction [1]. It can also be used as a pedicled flap in abdominal or perineum reconstruction. One of the most important property of the ALT flap is the low donor site morbidity, both functionally and aesthetically, compared to other workhorse flaps, thanks to the possibility to reach a direct suture in 80% of the cases. Many possibilities are currently available to cover the defect when direct suture is not achievable. A split thickness skin graft has traditionally been used to address the remaining skin defect. Due to the alteration of the thigh skin sensitivity and poor aesthetic outcomes, loco-regional flaps are gaining tremendous momentum in the field. In fact, they allow surgeons to get the donor site closure in one stage surgery, with a good tissue quality, with a like-with-like tissue. A systematic review according to the PRISMA guidelines was performed concerning the issue of donor site closure after ALT harvesting.