Versatility of the Free Vastus Lateralis Muscle Flap

Spyriounis, Petros K.; Lutz, Barbara S.

doi:10.1097/ta.0b013e3181647c61

Cited by 17 publications

(20 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The versatility of the anterolateral thigh is unparalleled22–31; no other donor site provides such a large amount of soft tissue – skin, muscle and fascia – with so little donor morbidity. In our practice, it is the workhorse soft tissue flap and has largely replaced the radial forearm flap, which was the most common soft tissue flap used prior to the rise of the anterolateral thigh flap.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Anterolateral thigh flap

2009

View full text Add to dashboard Cite

The anterolateral thigh (ALT) flap is a versatile soft tissue flap. It can be harvested as a fasciocutaneous or myocutaneous flap. Vascularized fascia can be included or the pedicle may be harvested as a flow-through flap. The flap can also be harvested incorporating multiple skin islands or as a chimeric flap incorporating separate skin and muscle components. When a large flap is needed, the entire lateral thigh can be harvested by combining the ALT with either the tensor fascia lata or the anteromedial thigh flap as a conjoined flap. Morbidity is remarkably minimal despite the availability of such generous amounts of tissue. The purported difficulty with the use of this flap is because of the anatomical variations that may render this flap unreliable. This paper clarifies the vascular anatomy of the flap and elaborates an approach to flap harvest that can be used to reliably harvest the flap in spite of the anomalies that may be encountered.

show abstract

Section: Discussionmentioning

confidence: 99%

“…When a thin flap is needed, it can be thinned to about 5 mm by excision of subcutaneous tissue 25. It can be harvested as a muscle flap (vastus lateralis muscle flap) based on the descending branch of the lateral circumflex femoral artery 29, 30. The flap can be sensate by inclusion of the lateral femoral cutaneous nerve 9.…”

Section: Discussionmentioning

confidence: 99%

Anterolateral thigh flap

2009

View full text Add to dashboard Cite

show abstract

“…However, in studies which took VL muscular flaps only without a skin paddle, the rate of contour deformity was 18.6% (8/43 flaps). 12,26,27 Overall, 18 studies reported on pain lasting longer than 6 months, which affected 2.6% (19/713) of these cases. One prospective study found the pain to be a significant factor in 14.7% (10/68) of donor-sites at 6 months.…”

Section: Anterolateral Thigh Flapmentioning

confidence: 99%

“…4 Musculoskeletal dysfunction following flap harvest was reported via subjective evaluation in 29 studies and objectively in 4 studies. 5,12,13,[26][27][28][29][30][31][32][33] Two studies found a significant reduction in isokinetic contractile force of 20 and 26% when compared with the contralateral extremity. 5,29 The remaining two studies found no significant difference in the force of contraction.…”

Section: Anterolateral Thigh Flapmentioning

confidence: 99%

Donor-Site Morbidity Following Free Tissue Harvest from the Thigh: A Systematic Review and Pooled Analysis of Complications

Lakhiani

DeFazio

Han

et al. 2016

J reconstr Microsurg

View full text Add to dashboard Cite

Background Donor-site morbidity significantly influences patient satisfaction and quality of life following reconstructive surgery. The relevant donor-site morbidities associated with more commonly utilized thigh-based flaps are reviewed. Methods A systematic search of the MEDLINE and Cochrane databases from 1994 to 2014 was conducted to identify all reports of "anterolateral thigh (ALT)," "vastus lateralis (VL)," "anteromedial thigh (AMT)," "transverse upper gracilis (TUG)," tensor fascia latae (TFL)," "gracilis," and "rectus femoris (RF)," flaps. Only studies that investigated donor-site outcomes related to pain, paresthesia, wound dehiscence, infection, hematoma, seroma, contour deformity, and/or objective functional performance were included. Case series or anecdotal reports with less than five flaps, non-English, and animal studies were excluded. Results A total of 116 articles representing 4,554 flaps were reviewed, including 2,922 ALT/VL, 148 AMT, 436 TUG, 278 TFL, 527 gracilis, and 243 RF flaps. The most frequently cited donor-site complication was paresthesia (range: 0-36.4%), followed by wound dehiscence (range: 0.9-8.3%), contour deformity (range: 0-5.2%), pain (range: 0-6.3%), and seroma (range: 0.4-2.0%). Despite mixed results regarding functional performance, pooled-analysis of dynamometric studies demonstrated a significant reduction in strength only after RF flap harvest (21%). Conclusions Donor-site morbidity for thigh-flaps is minimal and appears to be well-tolerated by the majority of patients. Nevertheless, the appropriate flap selection is highly individualized, and patients must be informed of potential complications and morbidities specific to each flap. We have established the most current review of donor-site morbidity for thigh-based flaps to aid the surgeon in this important discussion.

show abstract

“…Regarding VLMN donor site, Spyriounis and Lutz in a series of 24 free vastus lateralis flaps reported that no patient suffered any obvious functional limitation regarding knee extension. One patient suffered limited extension early postoperatively, with constant improvement after rehabilitation.…”

Section: Discussionmentioning

confidence: 99%