Clinical experience with a reverse-flow anterolateral thigh perforator flap for the reconstruction of soft-tissue defects of the knee and proximal lower leg

Versatility and “flap efficiency” of pedicled perforator flaps in lower extremity reconstruction

“…Arterial insufficiency was not seen in our series but has been encountered in other studies. 24,25 We found venous congestion frequent with the RF-ALT flap (50%), which we prospectively addressed by venous supercharging. The incidence of venous congestion has been reported as 6% in other series where the flaps were smaller.…”

“…The incidence of venous congestion has been reported as 6% in other series where the flaps were smaller. 24 On the basis of this, we advocated venous supercharging using the great saphenous vein if congestion occurs on table. 26 The need for microsurgery in such cases can be considered a major limitation of this flap.…”

Distally based split vastus lateralis myocutaneous flap for reconstruction of post electrical injury defects around knee joint

“…Various studies where authors have used whole of vastus lateralis muscle as distally based flap reported varying degree loss of knee extension. 5,[10][11][12] However inclusion of part of muscle decreases the chances of venous congestion and increases reliability of skin paddle. 11,13 Preserving the major part of vastus lateralis along with its motor nerve preserves the knee joint extension and knee function.…”

“…5,[10][11][12] However inclusion of part of muscle decreases the chances of venous congestion and increases reliability of skin paddle. 11,13 Preserving the major part of vastus lateralis along with its motor nerve preserves the knee joint extension and knee function. 8 Review of literature on split vastus lateralis myocutaneous flap shows two recent studies in which the flaps were done for post traumatic defects.…”

Colgajo anterolateral de muslo pediculado para cobertura de defectos oncológicos

“…Zhang en 1990 publicó la primera serie de casos utilizando este colgajo basado en la anastomosis que existe entre la rama descendente de la arteria circunfleja femoral lateral y la arteria femoral profunda o rama genicular lateral superior (2,3). También se ha empleado para defectos abdominales (4), perineales (5), inguinales (6), úlceras trocantéreas, sacras e isquiáticas (7), e incluso como colgajo de flujo reverso para la cobertura de defectos de rodilla y de tercio proximal de la pierna (8). Aún así, a pesar de no ser una técnica nueva, su uso no está tan difundido en nuestro medio como se podría considerar ante la diversidad de defectos de tejido en que sería de utilidad.…”