Comparisons of fascio‐cutaneous anterolateral thigh and sandwich fascial ALT free flap in the distal extremity reconstruction

Microsurgery ◽  
2019 ◽  
Vol 40 (4) ◽  
pp. 452-459
Author(s):  
Mario Cherubino ◽  
Chiara Stocco ◽  
Mario Ronga ◽  
Federico Tamborini ◽  
Francesca Maggiulli ◽  
...  
Keyword(s):  
Free Flap ◽  
Distal Extremity ◽  
Anterolateral Thigh ◽  
Extremity Reconstruction

Use of the chimeric anterolateral thigh free flap in lower extremity reconstruction

Microsurgery ◽  
2015 ◽  
Vol 35 (8) ◽  
pp. 634-639 ◽  
Author(s):  
Sang Woo Kim ◽  
Kyu Nam Kim ◽  
Joon Pio Hong ◽  
Sung Woo Park ◽  
Chae Ri Park ◽  
...  
Keyword(s):  
Lower Extremity ◽  
Free Flap ◽  
Anterolateral Thigh ◽  
Lower Extremity Reconstruction ◽  
Extremity Reconstruction

Super-Thin and Suprafascial Anterolateral Thigh Perforator Flaps for Extremity Reconstruction

2017 ◽  
Vol 33 (07) ◽  
pp. 466-473 ◽  
Author(s):  
Akhil Seth ◽  
Matthew Iorio
Keyword(s):  
Soft Tissue ◽  
Soft Tissue Reconstruction ◽  
Flap Reconstruction ◽  
Venous Anastomosis ◽  
Distal Extremity ◽  
Anterolateral Thigh ◽  
Effective Option ◽  
Tissue Reconstruction ◽  
Extremity Reconstruction ◽  
Alt Flap

Background The anterolateral thigh (ALT) flap remains a workhorse for soft tissue reconstruction. However, the traditional ALT flap is often too bulky for resurfacing shallow, distal extremity defects, prohibiting adequate function, or well-fitted orthotics. This study evaluates extremity reconstruction using ALT flaps elevated in the suprafascial or super-thin plane. Methods Retrospective review of ALT free flap reconstruction from October 2014 to July 2016 was performed. Suprafascial and super-thin flaps were those elevated just above the crural fascia and within the superficial scarpal plane, respectively. Adjunct operative procedures, demographics, and complications were recorded. Results A total of 25 patients underwent suprafascial (n = 14) or super-thin (n = 11) ALT flap reconstruction for primarily lower extremity wounds (n = 19), with an average age and body mass index of 53.8 years and 26.3 kg/m2, respectively. Follow-up was 6.3 months. Comorbidities included smoking (n = 7), diabetes (n = 8), peripheral vascular disease (n = 6), and hypertension (n = 8). The presence of hardware (n = 9), trauma (n = 10), and chronic infection (n = 12) were common risk factors. Average flap size was 8.2 × 21.5 cm, with 64% (n = 16) taken on one perforator. Forty-eight percent (n = 12) were end-to-side anastomoses and 62% (n = 13) utilized one venous anastomosis. Mean hospital stay was 7.8 days with a 24% (n = 6) complication rate. There were no partial or complete flap losses. Conclusion The ALT flap, elevated in a suprafascial or super-thin plane, is a safe, effective option for extremity soft tissue reconstruction. The decreased flap volume and bulk provides the improved contour and pliability necessary for appropriate distal extremity function. The potential versatility of super-thin flaps reinforces the importance of continued innovation by reconstructive microsurgeons.

scholarly journals Lower Extremity Reconstruction with Vascularized Free-Tissue Transfer: 20 Years of Experience in the Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand

2021 ◽  
Vol 73 (7) ◽  
pp. 462-470
Author(s):  
Nutthawut Akaranuchat
Keyword(s):  
Survival Rate ◽  
Lower Extremity ◽  
Free Flap ◽  
Free Tissue Transfer ◽  
Flap Surgery ◽  
Free Flap Surgery ◽  
Anterolateral Thigh ◽  
Lower Extremity Reconstruction ◽  
Extremity Reconstruction ◽  
The Mean

Objective: The reconstruction of extensive soft-tissue defects in the lower extremity still poses a great challenge to plastic and reconstructive surgeons. The ideal approach is to achieve a proper soft-tissue coverage with a well-vascularized flap, which results in a durable weight-bearing surface and permits normal joint motion. This study aims to retrospectively analyze the outcomes of lower-extremity reconstruction with vascularized free-tissue transfer performed at our plastic surgery division. Materials and Methods: A retrospective chart review was performed regarding 58 patients with defects in the lower extremity which were reconstructed with vascularized free-tissue transfers between 2000 and 2019. Forty-four of the patients were male, and 14 were female. The mean age was 44.4 years (range: 6-89 years). The most common indication for free-flap surgery was a secondary reconstruction after tumor eradication (23 cases, 39.7%), and 84.8% of the defects were exposed bare bones, tendons, or joints.Results: In our 58 reviewed cases, the foot was the most common area requiring reconstruction with a free flap (68.9%), and the mean defect size was 12.5 x 8.1 cm. The most commonly used free flap was the Anterolateral thigh free flap (39.7%), followed by the Gracilis free flap (29.3%), and the Superficial circumflex iliac artery-perforator free flap (10.4%). The recipient vessels most frequently used were posterior tibialis vessels (53.4%). The overall flap-survival rate was 75.9%, though there was an increased survival rate of up to 85.7% in the last five years of the period studied. The flap-salvage rate was 40.9%, and arterial thrombosis was the major cause of flap loss (50%). Factors associated with free-flap failure were re-exploration and free flap surgery after tumor or cancer eradication. The most common post-operative complication was flap-wound dehiscence (10.3%). Two patients received a flap correction due to bulkiness, and three had recurrence of ulceration. Conclusion: Microvascular free-tissue transfers for lower- extremity-defect reconstructions are reliable and valuable as a surgical technique. In over 20 years of experience in our division, we’ve had an overall flap-survival rate of 75.9%. Our flap of choice was the Anterolateral thigh free flap.

Use of the Anterolateral Thigh Free Flap for Upper-Extremity Reconstruction

2005 ◽  
Vol 30 (4) ◽  
pp. 859-864 ◽  
Author(s):  
Howard T. Wang ◽  
James W. Fletcher ◽  
Detlev Erdmann ◽  
L. Scott Levin
Keyword(s):  
Upper Extremity ◽  
Free Flap ◽  
Anterolateral Thigh ◽  
Extremity Reconstruction

Bowel Perforation Due to Immobilization after Resurfacing Thumb with Anterolateral Thigh Free Flap in an Elderly Diabetic Woman

2017 ◽  
Vol 26 (1) ◽  
pp. 18-22
Author(s):  
Seong Hoon Park ◽  
Joo Hyun Kim ◽  
In Suck Suh ◽  
Kwang Yong Kim ◽  
Hii Sun Jeong
Keyword(s):  
Free Flap ◽  
Bowel Perforation ◽  
Diabetic Woman ◽  
Anterolateral Thigh

Evolution of the anterolateral thigh free flap

2017 ◽  
Vol 25 (5) ◽  
pp. 416-421 ◽  
Author(s):  
Evan M. Graboyes ◽  
Joshua D. Hornig
Keyword(s):  
Free Flap ◽  
Anterolateral Thigh
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