Soft-Tissue Reconstruction Using a Free Anterolateral Thigh Flap: Experience With 28 Patients

Abstract

The authors present their experience using the free anterolateral thigh fasciocutaneous flap for head and neck and extremity reconstruction. From January 2000 through March 2002, 28 free anterolateral thigh flaps were transferred to reconstruct various soft-tissue defects. All patients were operated by two teams. All flaps were elevated based on one perforator only. The sizes of the flaps ranged from 9 x 11 to 20 x 26 cm. The success rate was 96.5% (27 of 28), with one partial failure. The cutaneous perforators were always found. Septocutaneous perforators were found in 3 of 28 patients (10.7%). Musculocutaneous perforators (89.3%) were found in the remaining patients, and the number of perforators ranged from two to five (average, three perforators). In 4 patients, flaps were used for sensate reconstruction. The authors used the anterolateral thigh flap as a thin flap in 10 patients. Mean follow-up was 13.5 months (range, 2-25 months). Soft-tissue reconstruction with the free anterolateral thigh flap in various regions of the body provides an excellent functional and cosmetic result with minimal donor site morbidity. The anterolateral thigh flap has many advantages over other conventional free flaps and it seems to be an ideal choice for the reconstruction of soft-tissue defects.

Functional outcomes and donor site morbidity following circumferential pharyngoesophageal reconstruction using an anterolateral thigh flap and salivary bypass tube

“…18 Finally, size of the skin paddle with the ALT can be much larger than the RFF. Sizes of up to 20 cm 3 26 cm have been reported in the literature 21 . Salivary bypass tubes were first used to divert salivary flow in patients who developed fistulae.…”

The Role of the Anterolateral Thigh Flap for Pharyngoesophageal Reconstruction

“…Koshima et al 4 originally reported a maximum dimension of 25 ϫ 18 cm. Recently, Yildirim et al 5 reported a maximum dimension of 20ϫ 26 cm. In our experience, the large skin paddle is reliable and ideal for pharyngoesophageal reconstruction.…”

A systematic review of anterolateral thigh flap donor site morbidity

“…T he anterolateral thigh (ALT) flap, first described as a septocutaneous perforator-based flap by Song et al (1) in 1984, has recently gained popularity and has become an important option for reconstruction of multiple anatomical locations such as the head and neck (3)(4)(5)(6)(7)9,10,(12)(13)(14)16,(18)(19)(20)(21)(22)(23)(25)(26)(27)(28)(29)(30)32,34,36,38,39,(41)(42)(43), upper (15)(16)(17)(18)(19)26,32,35,37,38,42) and lower (8,(16)(17)(18)(19)22,24,…”