Comparison of free anterolateral thigh flaps and free muscle‐musculocutaneous flaps in soft tissue reconstruction of lower extremity

Abstract

ALT perforator flap is a precious option for lower extremity soft tissue reconstruction with minimal donor site morbidity. Nevertheless, the beginners should be attentive to an increased rate of flap complications with the ALT flap and free axial muscle-musculocutaneous flaps would still be the tissue of choice for coverage of leg defects for a surgeon before gaining enough experience with perforator flap dissection.

Secondary Extremity Reconstruction for Contour Deformity: Case Report

“…[7][8][9] However, its suitability for extremity, particularly post-traumatic reconstruction, has only recently been appreciated. [10][11][12][13] Therefore the ALT flap was our flap choice for its previously mentioned advantages. Thickness-controlled ALT flap is well suited for our reconstruction case in the extremity because it provides large quantities of supple tissue with relatively low donor morbidity.…”

Retalho supramaleolar de fluxo reverso: aplicações clínicas

“…O terço inferior da perna, especificamente, é um local de estruturas com função dinâmica (tendões e articulação do tornozelo) e os retalhos menos espessos, com fibrose menor e, portanto, com mais elasticidade, permitem um resultado funcional e estético melhor em áreas doadoras e receptoras 7 aumento na sua indicação para cobertura, sobretudo nas regiões distais do membro inferior 8,9 . Em 1991, Hyakusoku descreve o retalho em hélice, o propeller flap, que pode ser rodado em 180º, tendo como base a perfurante como seu eixo 10 .…”

“…Os retalhos fasciocutâneos ampliaram as possibilidades de cobertura cutânea adequada de lesões de pequenas e médias extensões em regiões onde é mais difícil, como nas regiões distais da perna, tornozelo e pé 21 . Os retalhos menos espessos oferecem características ideais (like to like): cor, espessura e textura semelhantes; ter pedículo constante preditível e reprodutível, aceitável morbidade de área doadora; evita sacrifício de artéria e músculos e, além de oferecer tempos cirúrgicos com tempos menores, menos complexos (incluindo o tipo de anestesia) 7,13 , com riscos semelhantes aos de outros retalhos.…”

Untitled

“…Although muscle and musculocutaneous flaps are taken from latissimus dorsi or rectus abdominous donor sites have traditionally been utilized for coverage of such defects, in recent times there has been increasing evidence to support the use of the free fasciocutaneous anterolateral thigh (ALT) flap in posttraumatic reconstruction of the distal lower limb. [1][2][3][4] Many features of the ALT flap make it ideal for soft tissue repair in the distal lower limb, including its large skin territory, long, and robust vascular pedicle, the potential for sensory preservation, and minimal donor-site morbidity. 1 First described by Song et al as a novel free flap concept for head and neck reconstruction, the ALT flap has since established itself as an excellent choice for primary coverage of traumatic soft tissue defects in the lower extremity.…”

“…1 First described by Song et al as a novel free flap concept for head and neck reconstruction, the ALT flap has since established itself as an excellent choice for primary coverage of traumatic soft tissue defects in the lower extremity. 5-7 Song et al first described a possible area of 800 cm 2 , with a pedicle that ranged from 10 to 12 cm, although pedicles have been reported up to 16 cm, and a thickness that varied along its length from 1 to 3 cm. [5][6][7][8] The ALT is a versatile flap which can cover a variety of anatomic sites including the scalp, head and neck, trunk, and lower extremity with a low rate of dehiscence (3.8%), hematoma/seroma (1-2%), and skin grafting for the donor site(14.5%), it is an aesthetic choice with a scar easily hidden by wearing pants or shorts.…”