Alternative reconstructive choices for anterolateral thigh flap dissection in cases in which no sizable skin perforator is available

Abstract

When no sizable perforator is encountered, successful reconstruction could still be achieved by the proposed alternative choices.

The Versatility of Pedicled Anterolateral Thigh Flap: A Tertiary Re-ferral Center Experience from India

“…Split ALT flap was described to cover irregular wounds and to minimize wastage and trimming of flap [18]. When the ALT flap failed or the perforators could not be found, some back up procedures like tensor fascia latae flap or anteromedial thigh flap could be utilised [19]. Bulkiness of the flap was not a problem in our series.…”

Reciprocal Dominance of the Anterolateral and Anteromedial Thigh Flap Perforator Anatomy

“…Small number of such ''rescue'' cases has been recently reported. 10,11 Shaw et al 12 also found that, by exploring the medial thigh, ''suitable vessels'' were found in 23 (79%) of 29 cases. In the present study, the authors hypothesized that such a balanced relationship may exist between the vascular territories of the ALT and AMT.…”

Anthropomorphic and perforator analysis of anterolateral thigh flap in Indian population

“…However, there is a possibility that the findings in the other thigh could be symmetrical. [23] Hence in such cases, it would have been better if colour Doppler/computed tomography (CT) angiography had been carried out previously to assess the quality of the perforator. Otherwise, it is better to go for an alternate donor site.…”

“…Shaw et al . [23] were able to accurately locate the perforators using Doppler examination in two-third of cases. But the disadvantages are the poor reliability with increasing body mass index (BMI), inability to differentiate the type and source of perforators.…”