Anthropomorphic and perforator analysis of anterolateral thigh flap in Indian population

Abstract

Background:Anterolateral thigh (ALT) flap is one of the most common flaps in the reconstruction armamentarium of plastic surgeons, but there is no published data about the flap characteristics in the Indian population. The aim of this study is to analyse the anthropomorphic characteristics of the ALT flap and the perforator details in Indian population.Materials and Methods:ALT flap details were studied in 65 patients of Indian origin comprising 45 males and 20 females. The study period is from August 2011 to July 2012. A prospective database of the Doppler findings, perforator and pedicle details and the flap morphology were maintained. The variables are analysed by using the SPSS, PASW statistics 18 software IBM®.Results:In nearly 75% of cases, the perforator was found within 4 cm of the pre-operative Doppler markings. The percentage of musculocutaneous and septocutaneous perforators was 61.8% and 38.2% respectively. The pedicle variation was found in 6 cases (9.23%). The average thickness of the thigh skin in Indians is similar to the western people, but thicker than the other Asian people. Flap thinning was performed in nine patients without any major complications.Conclusion:The perforator details and type in the Indian population are similar to the published reports from other parts of the world. We advise pre-operative Doppler examination in possible cases. The variation in pedicle anatomy should not be overlooked to avoid complications. The thickness of subcutaneous tissue of the flap is higher in Indians, but still can be safely thinned. The data of this study will serve as a guide for the ALT flap characteristics in Indian patients.

Thickness of skin and subcutaneous tissue of the free flap donor sites: A histologic study

“…For the racial differences, in one research, the English people had thicker thigh skin than Chinese . However, in other papers, similar thicknesses were reported (Table ) …”

“…The thickness including the skin and hypodermis of the thigh area varied according to the race, measuring methods, and sex. Generally, females had thicker thigh flap than male . For the racial differences, in one research, the English people had thicker thigh skin than Chinese .…”

“…Several authors have measured the thickness of lateral thigh areas with different methods (ultrasonography, intraoperative measurement, and calipers) . The thickness including the skin and hypodermis of the thigh area varied according to the race, measuring methods, and sex.…”

Perforating patterns of cutaneous perforator vessels in anterolateral thigh flaps for head and neck reconstruction and clinical outcomes

“…In Taiwan, Shieh et al [ 16 ] reported 83.8% MC perforators and 16.2% SC perforators, and Wei et al [ 5 ] reported that MC perforators account for 87.1% of perforators. In India, Seetharaman et al [ 18 ] have found 61.8% of MC perforators in India. In a cadaveric study, Choi et al [ 24 ] reported that MC perforators accounted for 82.5% of 160 perforators, while SC perforators accounted for 17.5% ( Table 1 ).…”