A Description of the Vascular Anatomy of the Tensor Fascia Lata Perforator Flap Using Computed Tomography Angiography

Powers, Jeremy M.; Martínez, Mariana Vallejo; Zhang, Shuhao; Kale, Santosh S.

doi:10.1097/sap.0000000000001424

Cited by 10 publications

(10 citation statements)

References 16 publications

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“…Local advancement aps often fail due to tissue tension and insu cient perfusion. A prior operative approach makes it even more di cult to get su cient soft tissue coverage [5,8,9]. While numerous reconstructive options have been used in the past, they are often associated with a high complication rate [1][2][3][4].…”

Section: Discussionmentioning

confidence: 99%

“…Its donor side including the dorsal aspect of the iliac crest is prone to complications as the often immobile patients are bed ridden and the harvest site may progress into a pressure sore if a wound healing complication arises. The vascular pedicle (ascending part of LCFA) is prone to traction damage from previous surgery [5].…”

Section: Discussionmentioning

confidence: 99%

“…These options are based on an intact and reliable vascular pedicle and intact muscular structures. The TFL, vastus lateralis and pedicled groin ap receive their vascular supply through the ascending branch of the lateral circum ex femoral artery (LCFA), which is often transected by the operative approach [5]. Besides this, there is considerable donor site morbidity, especially when transferring muscular aps into the defect.…”

Section: Introductionmentioning

confidence: 99%

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Pedicled ALT-flap for soft tissue reconstruction in the trochanteric area

Vater,

Moncher,

Schmidt

et al. 2023

Preprint

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Purpose: Coverage of soft tissue defects following surgery at the trochanteric area is challenging. Revision surgery in case of compromised wound healing may lead to soft tissue defects requiring reconstruction with pedicled or free flaps. Previous access to the hip joint may jeopardize neurovascular structures relevant to the flap. In this study, we evaluated if pedicled anterior lateral thigh (ALT) flap is a valueable option for soft tissue reconstruction in this situation. Methods: In this retrospective study, five patients were included. Defect etiology was tumor resection in one case, screw osreosynthesis in another case and total hip arthroplasty in three cases. All patients underwent reconstruction by proximal pedicled anterior lateral thigh (ALT) flap. Results: Pedicled ALT flap was a safe procedure in all cases. One patient showed delayed wound healing with need for additional surgery. No further complications were observed. Conclusion: Pedicled ALT flap transfer represents a reliable option for soft tissue coverage in the trochanteric area after primary surgery such as hip arthroplasty, osteosynthesis or tumor resection.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Pedicled ALT-flap for soft tissue reconstruction in the trochanteric area

Vater,

Moncher,

Schmidt

et al. 2023

Preprint

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“…Several published reports described converting to a tensor fascia lata (TFL) flap in the absence of perforators [28,29]. Recently, Powers et al [30] successfully described the perforator anatomy of the TFL compared to the ALT flap by performing a high-resolution computed tomography angiography (CTA). They reported of a significantly higher perforator density of the TFL compared to the ALT flap.…”

Section: Discussionmentioning

confidence: 99%

The vascularized fascia lata free flap: an anatomical study and clinical considerations

Janik

Hirtler

Traxler

et al. 2020

Eur Arch Otorhinolaryngol

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Purpose Fascia lata (FL) is often used as fascial component of the anterolateral thigh (ALT) flap in head and neck reconstruction. No distinct data exist on whether the FL has its own reliable vascular supply and whether the fascia alone can be harvested as a fascia lata free flap. Methods We dissected 25 thighs of 15 cadavers. The lateral circumflex femoral artery (LCFA) was identified, and the size of stained fascia and skin were measured after injection of methylene blue into the descending branch (DB). Finally, topography of fascial vessels was determined. Results Staining of fascia and skin paddle was found in all 25 cases. Ascending skin perforators of the DB of the LCFA gave off branches for supply of the FL enabling harvest of a fascia lata free flap. Septo-or musculocutaneous perforators pierced FL and entered skin within the proximal 38.6-60% of the thigh. The mean length and width of stained FL was 15.8 ± 4.1 cm and 8.7 ± 2.0 cm, respectively, and size of stained FL ranged from 40.0 to 336.0 cm 2. In 20 cases (80%), skin paddles were 2.4 times larger on average compared to corresponding FL. Conclusion We could demonstrate that the FL receives its own vascular supply from perforators of the DB originating from the LCFA. Hence, harvest of a fascia lata free flap is possible, reliable, and the size of the fascia is suitable for reconstruction of small and large defects of the head and neck.

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“…The presence and number of the tensor fascia lata perforators can vary. Cadaveric studies show that it may be absent in 5% of cases, and the number of perforators can range from 0 to 5 7,8 …”

Section: Complicationsmentioning

confidence: 99%

Anatomic Markers for Intraoperative Identification of the Heuter Interval in the Direct Anterior Approach to the Hip

Condell,

Kelly,

Mckenna

2023

Techniques in Orthopaedics

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A Description of the Vascular Anatomy of the Tensor Fascia Lata Perforator Flap Using Computed Tomography Angiography

Cited by 10 publications

References 16 publications

Pedicled ALT-flap for soft tissue reconstruction in the trochanteric area

Pedicled ALT-flap for soft tissue reconstruction in the trochanteric area

The vascularized fascia lata free flap: an anatomical study and clinical considerations

Anatomic Markers for Intraoperative Identification of the Heuter Interval in the Direct Anterior Approach to the Hip

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