Anterolateral Thigh Flap Donor-Site Complications and Morbidity

Abstract

The authors examined donor-site complications and morbidity in 37 patients after reconstruction with free or pedicled anterolateral thigh flaps. Intraoperative assessment included damage to the vastus lateralis muscle and whether the main pedicle of the rectus femoris muscle had been killed. Postoperative assessment of the donor site included wound healing, range of motion, muscle strength, gait, and sensation. Patients were surveyed with a questionnaire about fatigue in their activities of daily life and the appearance of the donor site. All 32 patients who underwent primary skin closure could perform activities of daily life normally, and most (87.5 percent) reported that donor-site appearance was satisfactory. However, the severity of donor-site dysfunction was related to the degree of damage to the vastus lateralis muscle, and most patients (87.5 percent) had some loss of sensation at the anterolateral aspect of the thigh. Because of adhesions between the meshed skin graft and the underlying fascia, range of motion at the hip and knee was limited in significantly more patients who had received split-thickness skin grafts (60 percent) than patients who had undergone primary skin closure (3.1 percent). Therefore, wider flaps or flaps harvested nearer the knee may increase donor-site morbidity. The authors concluded that the incidence of long-term morbidity with the anterolateral thigh flap is low, although it is increased when the flap includes the vastus lateralis muscle or is wider and requires additional skin grafting at the donor site.

Rotation arc of pedicled anterolateral thigh flap for abdominal wall reconstruction: How far can it reach?

“…Because the branch of the descending branch of lateral circumflex femoral artery (LCFA) is the dominant vessel of the RF muscle, severing the branch can induce ischemia of the RF muscle. 22,23 Therefore, it is recommended to evaluate the blood supply to the RF muscle by means of a clamp applied on the branch before its division. By positioning pedicles appropriately and severing the branches when needed, maximum advancement of flaps can be achieved.…”

Lambeaux perforants fins prélevés dans le plan du fascia superficialis : principe et technique opératoire

“…Ce geste de préservation de la graisse profonde trouve tout son sens quand le site donneur ne peut être refermé directement. La greffe de peau sur l'aponévrose musculaire peut être à l'origine de douleurs à la marche et d'une limitation de l'amplitude articulaire du genou lors de prélèvements de grandes palettes cutanées [14]. La technique de prélèvement dans le plan du fascia superficialis pourrait permettre de prévenir ce genre de complications.…”

Lambeau libre de grand dorsal pour reconstruction d’une perte de substance large et complète de la paroi abdominale. À propos d’une tumeur desmoïde

“…Selon la taille et la localisation de la perte de substance, plusieurs lambeaux sont possibles [6,7] : les lambeaux de grand droit ou de grand dorsal pour les localisations supérieures, le muscle rectus femoris (muscle droit antérieur), le lambeau antérolatéral de cuisse (vastus lateralis) [8], le muscle sartorius (muscle couturier) [9] et le tenseur du fascia lata [10] pour les localisations infé-rieures.…”