Anatomical comparison among the anterolateral thigh, the parascapular, and the lateral arm flaps

Busnardo, Fábio de Freitas; Coltro, Pedro Soler; Olivan, Marcelo V.; Faes, J; Lavor, Elizeu; Ferreira, Marcus Castro; Rodrigues, and Aldo J.; Gemperli, Rolf

doi:10.1002/micr.22357

Cited by 14 publications

(11 citation statements)

References 51 publications

(70 reference statements)

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“…The ALT flap has some favorable characteristics for microsurgical reconstruction: thin skin or skin which can be thinned, long pedicle, large amount of tissue to transplant, possibility of chimeric flap transfer with skin and muscle components, minimal morbidity of the donor site, possibility of primary closure of the donor area, and dissection at a supine position …”

Section: Discussionmentioning

confidence: 99%

Chimerical anterolateral thigh flap for plantar reconstruction

et al. 2015

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Section: Discussionmentioning

confidence: 99%

Chimerical anterolateral thigh flap for plantar reconstruction

et al. 2015

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“…Flap thickness is thinner than that of ALT flaps (6.32 mm vs. 9.8 mm). Though LAFF is reported to be thicker than RFFF (6.32 mm vs. 2.8 mm), our experience reveals that extremely thin septocutaneous flaps can be harvested through a more lateral epicondyle oriented approach than conventional one [18,20,21]. It was especially useful for tongue tip reconstruction where thin pliable flap characteristics play bigger roles in shaping the delicate dimension of the tip, providing more functional tongue mobility.…”

Section: Discussionmentioning

confidence: 90%

“…It is known for the thin, pliable, and hairless flap with primarily closable donor site lesser than 7 cm in width [16]. Average pedicle length is 8.90 cm [18]. LAFF can be the optimal option for hemi-tongue reconstruction over RFFF for the following reasons.…”

Section: Discussionmentioning

confidence: 99%

Exclusive tongue tip reconstruction of hemiglossectomy defects using the underrated lateral arm free flap with bilobed design

Oh¹,

Lee²,

Lee³

et al. 2019

Arch Craniofac Surg

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BackgroundTongue reconstruction is challenging with the unique function and anatomy. Goals for reconstruction differ depending on the extent of reconstruction. Thin and pliable flaps are useful for tongue tip reconstruction, for appearance and mobility. This study reports lateral arm free flap (LAFF) as a safe and optimal option for hemi-tongue reconstruction, especially for tongue tip after hemiglossectomy.MethodsThirteen LAFFs were performed for hemi-tongue reconstruction after hemiglossectomy from 1995 to 2018. Of the 13 patients, seven were male and six were female, age varying from 24 to 64 years.ResultsAll flaps healed uneventfully without complications. Donor sites were closed primarily. The recipient vessels for microvascular anastomosis were mainly superior thyroidal artery, external jugular vein. All patients returned to normal diet, with no complaints regarding reconstructed tongue and donor site.ConclusionThe LAFF is hairless, thin (especially with lateral epicondyle approach), and potentially sensate. They are advantageous features for tongue tip and hemi-tongue reconstruction. Donor site sacrifices the inessential posterior radial collateral artery, and the scar is hidden under short sleeve shirts. We believe that LAFF can be considered as the first choice flap for hemitongue reconstruction, over radial forearm free flaps.

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“…31 En un estudio anatómico, Busnardo y cols. 32 compararon las características anatómicas del colgajo anterolateral del muslo, el colgajo paraescapular y el colgajo anterolateral del brazo en 20 cadáveres. No encontraron diferencias significativas con respecto al espesor del colgajo, ni al diámetro del pedículo vascular.…”

Section: Discussionunclassified

“…32 La experiencia de los autores de este trabajo coincide con la de otros autores, 7,40 en que no se evidencia mayor dificultad técnica en trabajar en esta posición cuando el colgajo es elevado del mismo lado que el miembro por cubrir. Los reportes muestran que este colgajo ha sido realizado con éxito y seguridad incluso en pacientes muy jóvenes y ancianos.…”

Section: Discussionunclassified

Colgajo paraescapular en pérdidas postraumáticas de tejidos blandos de las extremidades. [Parascapular flap in post-traumatic soft-tissue loss at the limbs.]

Vanoli

Murillo

Centeno

et al. 2018

Rev. Asoc. Arg. Ort. y Traumatol

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ResumenIntroducción: El objetivo de este artículo es comunicar los resultados obtenidos con el uso del colgajo paraescapular para cubrir defectos severos postraumáticos de tejidos blandos en las extremidades. Materiales y Métodos: Estudio retrospectivo, descriptivo, de una serie de 20 pacientes a los que se les realizó un colgajo libre paraescapular para cubrir lesiones masivas combinadas postraumáticas de tejidos blandos en las extremidades, entre 2006 y 2017. La edad de los pacientes promedió 30 años (18 hombres, 2 mujeres). La localización de las lesiones fue: 10 en antebrazo y muñeca, una en la región inguinal, siete en la pierna y dos en tobillo/pie. Resultados: El seguimiento promedio fue de 3.6 años. Se logró la cobertura exitosa en 17 casos. El tamaño de los colgajos promedió 24,8 x 10,7 cm. Seis casos presentaron lesiones vasculonerviosas que necesitaron injerto, seis se asociaron a pérdidas óseas, 11 requirieron injerto de piel y cuatro, reconstrucciones tendinosas. En todos los pacientes, el área donante cerró en forma primaria y sin secuelas funcionales. Dicho colgajo se combinó con el escapular en tres casos y con colgajo de dorsal ancho en tres casos. Dos colgajos fallaron y debió amputarse la extremidad lesionada; un paciente falleció por embolia masiva al séptimo día de la cirugía. Conclusiones: El colgajo paraescapular permitió salvar y reconstruir satisfactoriamente defectos masivos extensos en 17 de 20 extremidades, sin morbilidad para la zona donante del colgajo, pero su uso no está exento de complicaciones, y un abordaje multidisciplinario es necesario para disminuir esta morbilidad. The aim of this paper is to present the results after the use of parascapular free flaps to cover severe softtissue defects at the extremities. Methods: A retrospective, descriptive study of 20 patients who received parascapular free flaps to cover massive combined soft-tissue lesions at the extremities as a salvage procedure from 2006 to 2017 was performed. Patients' age averaged 30 years (18 men, 2 women). Sites of lesions were: ten at the forearm and wrist, one at the inguinal region, seven at the leg and two at the ankle/foot. Results: Follow-up averaged 3.6 years. Successful coverage was achieved in 17 cases. Flap size averaged 24.8 x 10.7 cm. There were six cases with neurovascular lesions that needed grafting, six cases had associated bone loss, eleven patients needed skin graft and four required tendon reconstructions. Donor area closed primarily without functional limitations in all patients. In three cases the flap was combined with a scapular flap and in three cases with a latissimus dorsi flap. Two flaps failed and the injured limb was amputated; one patient died due to massive embolism seven days after surgery. Conclusions: Parascapular free flaps allowed salvage and reconstruction of 17 out of 20 severely injured limbs, without morbidity for the donor area. But its use is not free of complications, and a multidisciplinary approach is necessary to reduce this morbidity.

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Anatomical comparison among the anterolateral thigh, the parascapular, and the lateral arm flaps

Abstract: The vascular pedicle length of anterolateral thigh flap was the longest and that lateral arm flap presented a pedicle with the smallest arterial and venous diameters, in addition to being the thinnest flap.

Cited by 14 publications

References 51 publications

Chimerical anterolateral thigh flap for plantar reconstruction

Chimerical anterolateral thigh flap for plantar reconstruction

Exclusive tongue tip reconstruction of hemiglossectomy defects using the underrated lateral arm free flap with bilobed design

Colgajo paraescapular en pérdidas postraumáticas de tejidos blandos de las extremidades. [Parascapular flap in post-traumatic soft-tissue loss at the limbs.]

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