To thin or not to thin: the use of the anterolateral thigh flap in the reconstruction of intraoral defects

Ross, Gary; Dunn, Roderick; Kirkpatrick, James J.; Koshy, C.E.; Alkureishi, Lee W. T.; Bennett, Nicholas; Soutar, David S.; Camilleri, I.

doi:10.1016/s0007-1226(03)00126-7

Cited by 132 publications

(86 citation statements)

References 15 publications

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“…However, during the immediate intraoperative debulking, the risk for partial necrosis may increase as the debulking procedures are performed without a distinction of an anatomical plane. 13,14 The best way may be to dissect with direct visualization of the small branches traveling into the dermal plexus under a microscope. 6 But this maybe a very tedious and a time consuming task.…”

Section: Discussionmentioning

confidence: 99%

“…18,19 On the basis of this knowledge, a large thin flap will survive even though without direct linking vessels. 13,17 Therefore, despite debulking the deep fat where the direct linking vessels might be found, the thin flap harvested on the superficial plane will still have adequate blood supply. This hypothesis was proven to be an adequate one as 304 consecutive flaps elevated on the superficial fascia had a 97% survival rate and the largest dimension reached up to 30 Â 18 cm based on a single perforator.…”

Section: Discussionmentioning

confidence: 99%

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A New Plane of Elevation: The Superficial Fascial Plane for Perforator Flap Elevation

Hong

Choi

Suh

et al. 2014

J reconstr Microsurg

152

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Background?The aim for microsurgical reconstruction has broadened from achieving functional to also providing good esthetic outcomes. The perforator flaps are widely used for this goal. However, perforator flaps can still be bulky especially to resurface the skin defect. We hypothesized that elevation from the superficial fascial plane can obtain a thin and viable flap. Method?In this retrospective study, we report consecutive perforator flaps elevated at the superficial fascial plane from November 2007 to July 2013. Total of 304 flaps which were 196 superficial circumflex iliac perforator (SCIP) flaps, 81 anterolateral thigh (ALT) flaps, and 27 gluteal artery perforator (GAP) flaps were reviewed. Result?The patient group composed of 189 male and 115 female patients with an average age of 35.8 years. The average body mass index was 23.5 kg/m2 (range, 15.91?34.57 kg/m2). All 304 flaps were successfully elevated with this approach with at least one viable perforator. The thickness averaged approximately 6?mm for ALT flap (range, 4?11 mm), 5?mm for SCIP flap (range, 3?12 mm), and 8.5?mm for GAP flap (range, 5?11 mm). Complete survival was noted in 282 flaps, partial loss of flaps requiring secondary procedures in 6 cases, partial loss healing secondarily in 8 cases, and total loss in 9 cases. During the average follow-up of 34 months, secondary debulking procedures were required in six flaps. Conclusion?This new approach of elevation on the superficial fascia is reliable, provides a viable tissue, and is able to obtain a thin flap achieving good functional and esthetic outcome.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

A New Plane of Elevation: The Superficial Fascial Plane for Perforator Flap Elevation

Hong

Choi

Suh

et al. 2014

J reconstr Microsurg

152

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“…Subcutaneous fat thinning as a 1-stage procedure has been described and used in a East Asian population to overcome this limitation. 10,11 However, these techniques have not been reported extensively in a Western population. In fact, thinning the ALT flap during the primary reconstruction has been cautioned as increasing the risk for major complications by loss of flap viability.…”

Section: Ince Its Initial Descriptionmentioning

confidence: 99%

Comprehensive Analysis of the Anterolateral Thigh Flap Vascular Anatomy

Seth¹,

Manz²,

Dahan³

et al. 2011

Arch Facial Plast Surg

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“…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,…”

mentioning

confidence: 99%