Decreasing ALT donor site morbidity with the keystone flap

Turin, Sergey Y.; Spitz, Jared A; Alexander, K Skaria; Ellis, Marco F.

doi:10.1002/micr.30317

Cited by 19 publications

(26 citation statements)

References 21 publications

(26 reference statements)

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“…Visconti and Salgarello () reported two cases in which the primary closure of the donor site of the free ALT flaps was achieved by V‐Y advancement of a local anterolateral thigh (AMT) flap, based on perforators of the superficial femoral artery (SFA). Recently Turin et al () descried six cases of primary closure of free ALT donor site with advancement key stone flaps with reasonable results.…”

Section: Discussionmentioning

confidence: 99%

Propeller flap donor site closure by means of another propeller flap: A case report and literature review

2019

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Despite some ongoing criticisms, propeller flaps are still gaining popularity among plastic surgeons. The need of skin grafting of the donor site is one of those limitations that sometime affect the beauty and the efficacy of this reconstructive technique. Similar to a classic bi‐lobed skin flap in which the second lobe of the same flap is mobilized to cover the donor site defect of the first lobe, a second, discrete propeller flap can be harvested adjacent to the first, in order to close the first donor site defect, thus avoiding the need for a skin graft. We applied this concept of “sequential” propeller flaps to cover a 4.5 × 4 cm full thickness soft tissue defect at the level of the heel in a 54‐year‐old patient who underwent melanoma excision and sentinel node biopsy.The first and second propeller flaps of 10 × 4.5 cm respectively were rotated on a distal and on a more proximal perforator of the posterior tibial artery (PTA) respectively, obtaining a tension free closure along the entire wound. The post‐operative course was uneventful and the patient returned to full normal activities after 4 weeks. Follow up at 6 months showed a stable reconstruction with no functional deficit. This option, that relies on two separate perforator propeller flaps performed in sequence to obtain complete wound closure, may be kept in mind when dealing with soft tissue defects eligible for propeller flap reconstruction, as long as sizeable perforators in a favorable position are available. Moreover, a brief literature review on propeller flap use in flap donor site closure is also provided.

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Section: Discussionmentioning

confidence: 99%

Propeller flap donor site closure by means of another propeller flap: A case report and literature review

2019

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“…A medially based keystone advancement flap for closure of the ALT donor site can also be used to achieve primary closure in the ALT flap donor area, but is a big injury to the adjacent tissue and remain a obvious scar. [ 12 ] Deng et al [ 13 ] published a series of various surgical techniques based on the oblique branch increased the complexity of the design and required sophisticated surgical skills. In our study, we successfully reconstructed the large soft-tissue defects in the foot or hand and achieved primary closure of the ALT donor site in a relative constant and simple manner.…”

Section: Discussionmentioning

confidence: 99%

Outcomes of using a modified anteromedial thigh perforator flap for repairing the anterolateral thigh free flap donor site

et al. 2018

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The anterolateral thigh (ALT) flap plays an essential part in plastic and reconstructive surgery. However, repair of the anterolateral donor site has not been the focus of the clinicians.To assess the clinical value and feasibility of using a modified anteromedial thigh (AMT) perforator flap for repairing the ALT free flap donor site.In this retrospective study, 16 ALT flaps were transferred to resurface large soft-tissue defects (ranged from 7 × 5 to 13 × 8 cm) in the foot or hand from June 2012 to March 2013. The donor sites were repaired with an advancement flap pedicled with an AMT perforator. Sensation within the advancement flap, return-to-work (RTW) time, the aesthetic appearance of the donor sites, and functional recovery were measured.All 15 flaps survived completely without necrosis. One flap developed partial necrosis in the tip but healed with dressing changes after 1 week. The medain follow-up period was 3.5 months (range, 3–6 months). The average median time was 9.5 weeks (range 8–13 weeks). There was no numbness of the advancement flap. Additionally, there was no specific complication at both the recipient and donor sites. Thigh quadriceps muscle strength and activities of the knee were normal. All patients were satisfied with the aesthetic outcome postoperatively at the 3-month to 6-month follow-up.The modified advancement flap pedicled with an AMT perforator is an ideal option for repairing the anterolateral donor site.

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“…Visconti et al described the use of the anteromedial thigh (AMT) flap as local flap to reach primary closure of the ALT flap donor site (Visconti & Salgarello, ). Recently, Turin et al proposed the use of keystone flap for managing ALT flap donor site closure in difficult situations, and they showed good results (Turin, Spitz, Alexander, & Ellis, ). In contrast, flaps harvested from the medial and PMT are less employed and mainly they are harvested with a transverse design.…”

Section: Discussionmentioning

confidence: 99%

Perforator flap based on the third perforator of the profunda femoris artery (PFA)‐assisted closure of the free vertical posteromedial thigh (vPMT) flap donor site

2018

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Decreasing ALT donor site morbidity with the keystone flap

Cited by 19 publications

References 21 publications

Propeller flap donor site closure by means of another propeller flap: A case report and literature review

Propeller flap donor site closure by means of another propeller flap: A case report and literature review

Outcomes of using a modified anteromedial thigh perforator flap for repairing the anterolateral thigh free flap donor site

Perforator flap based on the third perforator of the profunda femoris artery (PFA)‐assisted closure of the free vertical posteromedial thigh (vPMT) flap donor site

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