Anterolateral Thigh Fasciocutaneous Flap in the Difficult Perineogenital Reconstruction

Abstract

A pedicled anterolateral thigh fasciocutaneous flap that was used to cover a complicated perineogenital defect after bilateral gracilis myocutaneous flap for perineal reconstruction is presented. The indications and advantages of this approach are outlined. This technique offers to the plastic surgeon and gynecologic oncologist a new option in the armamentarium for reconstruction of the perineum, and it offers the patient reduced donor-site morbidity.

Significance of anatomical variations of the lateral circumflex femoral artery for the tensor fasciae latae flapping

“…The results of our study prove that the main blood supply of the TFL muscle is provided by the terminal branches of the ascending branch of the LCFA, which is indicated by some other authors as well [12,13,16,21,28,36]. The frequency of branches supplying the muscle was reported by Saadeh [28].…”

“…The understanding that the bifurcation of the ascending branch of the LCFA enters the TFL muscle directly is of great importance when planning the flap [1,21,36]. The results of our study show that the number of terminal branches of the ascending branch which arise prior to the entrance into the muscle was 0-8.…”

“…The results of our study show that the number of terminal branches of the ascending branch which arise prior to the entrance into the muscle was 0-8. In most cases (45%) the number of the terminal branches is 3, which data is not supported by the literature stating that the number of branches of the ascending branch is usually 2 [12,20,21,36,37], except with the study conducted by Jovanovic et al [16].…”

Reconstruction of perineal defects

“…28 It is a fasciocutaneous flap of the lateral thigh based on perforators from the transverse branch of the lateral circumflex femoral artery ( Fig 5). The donor site defect can be closed directly if the width is less than 8cm but flaps of up to 15cm wide can be raised with grafting of the donor site.…”

Reconstruction of Perineum and Abdominal Wall

“…Recent reports describe its use in perineal reconstructions ( Yu et al 2002, Luo et al, 2000. Donor-site morbidity is minimal if a perforator-based anterolateral thigh flap is harvested (Lipa et al, 2005, Tsuji et al, 2008.…”