The Anterolateral Thigh Perforator Flap in an Innovative Microsurgery Training Method

Abstract

Summary:The road to becoming a good and confident microsurgeon requires love for your work, patience, and good training facilities. Safe and effective training procedures for young microsurgeons during their plastic surgery residency are necessary and should be applied under standardized conditions. We present an innovative microsurgical training method for plastic surgery residents in the operation theater concerning the anterolateral thigh perforator flap (ALT). In a 2-team approach, the ALT flap harvesting begins parallel to tumor resection. Although the tumor excision team still works in the tumor region, and after the reconstructive team has successfully completed the ALT dissection, residents can work distally to the origin of the perforator vessel (which supplies the flap). Their training involves dissection and anastomosis of the continuation of the descending branch, distally to the perforator supplying the flap. Since 2015, eight operations have been performed with this innovative method with the participation of upcoming microsurgeons. A written informed consent is given to all patients. Our study resulted in the improvement of microsurgical skills of the young microsurgeons. There is no impact to the ALT perforator flap or to the operative time. This training procedure can be safely applied as a training method during plastic surgery residency under standardized conditions. We have the joy of seeing our resident’s progress through their high success rates in microsurgery. We recommend this innovative procedure as an adequate teaching method during residency to promote the future of our specialty, and we hope that our students will become even better than their teachers.

Microsurgical education in Greece: past, present, and future

“…The educational ethic of spreading the knowledge for the development of new microsurgeons is reflected today in current microsurgical training; innovative methods are being employed by faculty for residents to be able to expand their technical skills with the elevation of anterolateral thigh flaps under Attending supervision [43]. Contemporary experimental microsurgical research is being conducted in several fields, such as nerve regeneration with an epineurial flap can be used to bridge a nerve defect [44].…”