Reconstruction of two separate defects in the upper extremity using anterolateral thigh chimeric flap

Abstract

We presented our experience on the use of anterolateral thigh (ALT) chimeric flap to reconstruct two separate defects in upper extremity. From December 2009 to August 2012, we used this ALT chimeric flap to reconstruct two separate defects in upper extremity on five patients (mean age: 36.6 years; range: 15 ∼ 47 years). The locations of defect were palm and fingers in four patients and forearm in the other patient. The sizes of defect ranged from 4.5 × 1.5 cm to 20 × 10 cm. A minimum of two separate perforator vessels in the flap were identified. The skin paddle was then split between the two perforators to shape two separate paddles with a common vascular supply. There were no cases of flap failure or re-exploration. Four donor sites were directly closed and one was covered by a skin graft. Donor-site morbidity was negligible. The ALT chimeric flap provides customized cover for two separate defects in upper extremity.

Salvage Free Anterolateral Thigh Composite Flap Transfer Based on the Musculocutaneous Perforator Retrograde Blood Flow Principle

“…4 Versatile and extensive chimeric flaps that include parts of the surrounding muscles and even segments of the iliac crest have been subsequently reported. [5][6][7][8][9][10][11][12] We have previously reported one of the largest studies with the use of anterolateral thigh adipofascial flap for the restoration of facial contour deformities. 2 The robustness and versatility of the ALT flap is further demonstrated in this article when the ipsilateral STA was not suitable for microanastomosis.…”

“…The treatment of obstructive sleep apnea syndrome (OSA) is surgery including mandibular osteotomy with genioglossus advancement, and in this case the accurate measurement of GTs is necessary for mandibular osteotomy, to avoid complications such as mandibular fracture along the inferior border, and paresthesia of the dentition, and to prevent dental root (central/lateral incisor) damage. 9,10 Due to lack of studies using CBCT on individuals with clefts, the anatomy and possible variations in the mandible region are not well known if these patients have only isolated clefts without associated syndromes and even with syndromes associated. The objective of this study was to evaluate the GTs in CBCT scans and perform their measurements in multiplanar reformatting in i-Cat Vision software.…”

Lengthening the pedicle of a scapular osseous free flap by angular branch reconnection within the subscapular artery system

“…This procedure only requires each artery/vein used to undergo a single anastomosis. In addition, this pedicle lengthening procedure is applicable to other free combined flaps with several branches or perforators …”

Using the proximal perforator-based anterolateral thigh flap from the same donor site to salvage the reconstruction after failure of the distal perforator-based anterolateral thigh flap

“…6,7 Peng et al successfully applied this technique to reconstruct two separate defects in the upper extremity at the same time. 8 Tripaddled ALT flap for simultaneous reconstruction of bilateral buccal defects after buccal cancer ablation and severe oral submucous fibrosis release was also successfully performed in a patient with three widely separated perforators on the ALT donor site. 9 All the aforementioned reports described that multiple skin flaps from one ALT donor site could be simultaneously harvested if two or more cutaneous perforators were available.…”

“…Reconstruction of separate defects with two or three skin paddles from one ALT donor site has been reported to be a useful technique. [4][5][6][7][8][9] Of those cases, multiple skin flaps from one ALT donor site were always harvested in a simultaneous fashion.…”