A new technique of transferring island pedicled anterolateral thigh and vastus lateralis myocutaneous flaps for reconstruction of recurrent ischial pressure sores

Lee, Jiunn-Tat; Cheng, Li-Fu; Lin, Chih‐Ming; Wang, Chien-Hsing; Huang, Chieh-Chi; Chien, Shu

doi:10.1016/j.bjps.2007.03.026

Cited by 34 publications

(21 citation statements)

References 14 publications

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“…They had 1 flap loss. These case reports and series from Lee et al 8 highlight the utility of the ALT flap for covering a wide range of defects including large posterior thigh defects. Because of the limited arc of rotation through lateral subcutaneous tunneling, a more direct approach allows for coverage of larger defects posteriorly and allows the reconstructive surgeon more flexibility when insetting the flap.…”

Section: Discussionmentioning

confidence: 91%

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Trans-vastus Intermedius Transfer of the Pedicled Anterolateral Thigh Flap for Posterior Thigh Reconstruction

Batdorf

Lettieri

Saint‐Cyr

2013

Plastic and Reconstructive Surgery Global Open

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Section: Discussionmentioning

confidence: 91%

“…Lee et al 8 described the transmuscular tunneling of the ALT flap for 16 recurrent ischial pressure ulcers (largest flap size 12 × 6 cm). They had 1 flap loss.…”

Section: Discussionmentioning

confidence: 99%

Trans-vastus Intermedius Transfer of the Pedicled Anterolateral Thigh Flap for Posterior Thigh Reconstruction

Batdorf

Lettieri

Saint‐Cyr

2013

Plastic and Reconstructive Surgery Global Open

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“…Comparatively, we had reported the transfer of island pedicled anterolateral thigh and vastus lateralis myocutaneous flaps directly through the intermuscular and intramuscular spaces of the upper thigh to reconstruct the ischial pressure sores. 5 Through our method, the distance to the defect to be reconstructed is shortened, as the tunnel that is created is the same as the distance when a bird flies (direct). The skin island of our flaps contained no muscle or only a small segment of muscle and could be located at the middle third of the thigh where vascularity is much better.…”

Section: Discussionmentioning

confidence: 99%

Expanding the Applications of the Pedicled Anterolateral Thigh and Vastus Lateralis Myocutaneous Flaps

Hsu¹,

Chien²,

Wang³

et al. 2012

Annals of Plastic Surgery

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We describe our experience in expanding the use of pedicled anterolateral thigh and vastus lateralis myocutaneous flaps. A total of 33 patients underwent 34 flaps between March 2003 and January 2012. The defects included 18 ischial, 3 trochanteric, 5 lower abdomen, 2 perineogenital, 1 groin, and 5 knee defects. There were 29 proximal pedicled (2 of which were preexpanded), 3 distal pedicled, and 2 propeller flaps. Complications included 1 total necrosis, 1 partial necrosis, 3 wound dehiscence in recipient site, 1 hematoma, and 1 donor-site dehiscence. The total flap survival rate was 94%. There were no donor-site morbidities except poor cosmesis in the skin-grafted sites. Pedicled anterolateral thigh flap is highly versatile with a wide arc of rotation. A proximal pedicled flap can be used for lower abdomen, perineogenital, ischial, and trochanteric defects and the distal pedicled or a propeller flap for knee and proximal lower leg defects.

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“…9 Among these, the vastus lateralis myocutaneous flap is superior to the other flaps in terms of a longer vascular pedicle and a larger volume of soft tissue, which allow for a wide arc of rotation and coverage of extensive soft-tissue defects. It has been used for management lower abdomen wall defects, 5,9 reconstruction of perineum, 10 and treatment of ischial pressure sores [11][12][13][14] and numerous other soft-tissue defects. 12,13 In dissection of the flap, one should trace the lateral circumflex femoral artery to its origin at the deep femoral artery and the flap should be transferred under the rectus femoris to increase reach.…”

Section: Discussionmentioning

confidence: 99%

One-Stage Posttraumatic Bladder Reconstruction and Soft-Tissue Coverage of the Lower Abdomen or Perineum

Wu¹,

Lin²,

Lin³

2010

Annals of Plastic Surgery

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Mutilating injury on pelvis may be complicated by urinary bladder ruptures and soft-tissue avulsion of the lower abdominal wall or perineum. With retraction of the avulsed abdominal wall or perineum, as well as bladder tissue loss secondary to trauma or infection, direct closure the injured bladder often leads to excessive tension, resulting in ischemia and eventual failure of repair. The authors successfully managed 4 patients with such injuries using the pedicled vastus lateralis myocutaneous flap. No major complications occurred and intact bladders were confirmed with cystograms. Three (75%) of them were able to void normally within 1 year. It is concluded that the pedicled vastus lateralis myocutaneous flap is an ideal option for posttraumatic bladder reconstruction and soft-tissue coverage of the lower abdomen or perineum; whereas the undersurface of the muscle serves as a substitute for the missing bladder wall, the remaining part of the muscle, as well as the subcutaneous fat, provide sufficient bulk for dead space obliteration.

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A new technique of transferring island pedicled anterolateral thigh and vastus lateralis myocutaneous flaps for reconstruction of recurrent ischial pressure sores

Cited by 34 publications

References 14 publications

Trans-vastus Intermedius Transfer of the Pedicled Anterolateral Thigh Flap for Posterior Thigh Reconstruction

Trans-vastus Intermedius Transfer of the Pedicled Anterolateral Thigh Flap for Posterior Thigh Reconstruction

Expanding the Applications of the Pedicled Anterolateral Thigh and Vastus Lateralis Myocutaneous Flaps

One-Stage Posttraumatic Bladder Reconstruction and Soft-Tissue Coverage of the Lower Abdomen or Perineum

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