A Technical Pearl to Ensure Reliable Harvest of the Anterolateral Thigh Myocutaneous Flap

ALDeek, Nidal Farhan; Tsao, Chung‐Kan; Kao, Huang‐Kai; Wei, Fu‐Chan

doi:10.1097/prs.0000000000001063

Cited by 3 publications

(2 citation statements)

References 4 publications

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“…8 As mentioned previously, the dorsal scapular artery perforator flap was selected based on "minimal" donor site morbidity. In previous descriptions, 9,10 the intramuscular dissection of the pedicle involved the deroofing technique popularized by Wei and colleagues. 2 Although this technique facilitates swift skeletonization of the perforators and decreased operative time, it does transect a portion of the muscular fibers.…”

Section: Discussionmentioning

confidence: 99%

The Dorsal Scapular Artery Perforator Flap: A Complete Muscle-sparing Technique

Marr

Varga

Dumestre

2021

Plastic and Reconstructive Surgery - Global Open

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Summary: Cervical and thoracic spine reconstruction can be a difficult area to provide stable soft tissue coverage. Historically, trapezius myocutaneous flaps and trapezius muscle turnover flaps have proven to be reliable and versatile methods for the reconstruction of these areas. However, sequelae such as restriction of shoulder movement have been reported, as well as unsightly “humpback” contour deformities from turnover flap bulk. The use of the trapezius muscle for coverage has evolved to include descriptions of a trapezius perforator flap to address some of the issues of donor site morbidity, as it is described as a muscle-sparing technique. Although described as “muscle-sparing,” these approaches nonetheless involve sacrifice of trapezius muscle overlying the pedicle as that musculature is “deroofed” and divided off the pedicle during dissection. In this article, we present a detailed technical description of our novel technique to the trapezius perforator flap using a dorsal scapular artery flap for spinal reconstruction that is truly, completely muscle-sparing. This technique may prove useful for those patients in which even minimal disruption of trapezius muscle fibers is undesirable.

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Section: Discussionmentioning

confidence: 99%

The Dorsal Scapular Artery Perforator Flap: A Complete Muscle-sparing Technique

Marr

Varga

Dumestre

2021

Plastic and Reconstructive Surgery - Global Open

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“…For intramuscular dissection, we use the deroofing technique popularized by Wei and colleagues. 3 The tenotomy scissors are slid directly over the perforator to create a tunnel. Monopolar diathermy is then carefully used over the tenotomy scissor to deroof the perforator.…”

Section: Technical Pointmentioning

confidence: 99%

Five Simple Techniques to Enable Rapid Elevation and Donor Site Closure of the Anterolateral Thigh Flap

Nikkhah

Miller

Pafitanis

et al. 2019

Journal of Hand and Microsurgery

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We describe five technical notes to facilitate rapid elevation of the anterolateral thigh flap for extremity reconstruction. We highlight the advantages of (1) a lateral approach; (2) identification of the perforator with the shortest intramuscular distance; (3) deroofing technique with cutting monopolar for pedicle dissection; (4) taking a cuff of vastus lateralis in some cases to avoid unnecessary long perforator dissection; and (5) closure of large donor sites with a modified keystone flap. Using the sequence reduces flap-raising times to 60 to 90 minutes and improves theater usage while achieving excellent outcomes.

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