Single perforator based anterolateral thigh flap for reconstruction of large composite defects of oral cavity

Kekatpure, Vikram D.; Trivedi, Nirav; Shetkar, Girish; Manjula, B.V.; Mohan, Alok; Kuriakose, Moni Abraham

doi:10.1016/j.oraloncology.2011.03.023

Cited by 35 publications

(17 citation statements)

References 20 publications

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“…It was originally described as a fasciocutaneous flap with septocutaneous perforators originating from the descending branch of the LCFA; however, anatomical studies have since shown significant variations in perforator anatomy. A systematic review by Lakhiani et al found that the described septocutaneous perforators were present in between 9.5% and 61.5% of cases, and perforators originated from the descending branch of the LCFA between 57% and 100% of patients . Other perforator origins included the LCFA itself, its anatomical branches (ascending, transverse and oblique), the common femoral artery and profunda femoris artery .…”

Section: Discussionmentioning

confidence: 99%

Anatomic symmetry of anterolateral thigh flap perforators: a computed tomography angiographic study

Chan

Ferris

et al. 2019

ANZ Journal of Surgery

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Background: The anterolateral thigh flap is a workhorse reconstructive flap. Versatility in design is a key strength but perforator anatomy can be variable. Inability to locate perforators prompts consideration of contralateral thigh exploration. However, such exploration would be futile if the absence of perforators proves symmetrical. This study assesses the symmetry of anterolateral thigh flap vasculature using computed tomography angiography (CTA). Methods: A retrospective analysis of 20 bilateral thigh CTAs was performed. Each limb was assessed for number, course, location and size of perforators. Only vessels >0.5 mm in size at origin were included. Location was standardized between patients using perforator distance/thigh length ratio. Results were analysed using Wilcoxon signed-rank test. Results: In each thigh, the average number of perforators was 3.58 and average perforator distance/thigh length ratio was 0.358 AE 0.08. Between both limbs of the same patient, the mean difference in number of perforators was 0.55 (P = 0.002), and difference in average perforator size was 0.3 mm (P < 0.001). Average perforator location differed by a mean of 3% of thigh length (P < 0.001) between thighs. Conclusion: While average vessel size and location appear similar, there does not appear to be symmetry in the number of perforators. Surgical exploration of the contralateral thigh in an absence of perforators should be considered. In patients where abnormal anatomy is expected, mapping with CTA could be considered to reduce morbidity associated with unsuccessful surgical exploration and dissection.

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Section: Discussionmentioning

confidence: 99%

Anatomic symmetry of anterolateral thigh flap perforators: a computed tomography angiographic study

Chan

Ferris

et al. 2019

ANZ Journal of Surgery

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“…[ 13 ] The main disadvantage of using anterolateral thigh flap is that it is bulky, so as to provide a taut surface for oral reconstruction, and patients also suffer from dark hair growth in oral cavity. [ 14 15 ]…”

Section: Discussionmentioning

confidence: 99%

Medial sural artery perforator flap for head and neck reconstruction

Agrawal

Gupta

Chaudhary

et al. 2018

Ann Maxillofac Surg

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Aim:The aim is to study the assessment of feasibility of medial sural artery perforator (MSAP) free flap for head and neck reconstruction at our center.Materials and Methods:Oral cancer patients with squamous cell carcinoma of the tongue, buccal mucosa, and floor of mouth cancer attending our center were reconstructed using MSAP flap after oncologic resection. Handheld 8 MHz Doppler was used to identify the perforator preoperatively.Results:We reconstructed 10 patients using MSAP flap. The flap was designed according to defect and donor site was primarily closed in all cases. Excellent results were seen in nine patients reconstructed with MSAP flap without any postoperative complication. Flap failure occurred in one patient due to venous thrombosis. The thickness of flap ranged from 4 to 8 mm. The vascular pedicle length ranged from 9 to 13 cm.Conclusion:The MSAP flap is appropriate for medium-sized oral defect reconstruction, with a long pedicle of matching caliber, adequate tissue volume, and minimal donor-site morbidity which makes it comparable to other microvascular free flaps such as radial artery free flap (RAFF) and anterolateral thigh flap.

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“…17 Recently, folded ALT flaps have also been used for the reconstruction of these defects. 7,8 However, satisfactory results cannot always be achieved, particularly if the corner of the mouth is excised.…”

Section: Discussionmentioning

confidence: 99%

“…1 There are several options including reconstruction with the pectoralis major flap, 2 radial forearm flap, 3,4 latissimus dorsi flap, 5 and anterolateral thigh flap (ALT). [6][7][8] Double flaps have also been used. 9,10 It is too difficult to achieve satisfactory functional and aesthetic results with a unifoliate flap, and although double flaps may meet the reconstructive requirements, the local damage and the operating time are increased because of the need for additional donor sites.…”

Section: Introductionmentioning

confidence: 99%

Chimeric flaps pedicled with the lateral circumflex femoral artery for individualised reconstruction of through-and-through oral and maxillofacial defects

Gong

Zhang

Wang

et al. 2015

British Journal of Oral and Maxillofacial Surgery

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Single perforator based anterolateral thigh flap for reconstruction of large composite defects of oral cavity

Cited by 35 publications

References 20 publications

Anatomic symmetry of anterolateral thigh flap perforators: a computed tomography angiographic study

Anatomic symmetry of anterolateral thigh flap perforators: a computed tomography angiographic study

Medial sural artery perforator flap for head and neck reconstruction

Chimeric flaps pedicled with the lateral circumflex femoral artery for individualised reconstruction of through-and-through oral and maxillofacial defects

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