Expanding the Applications of the Pedicled Anterolateral Thigh and Vastus Lateralis Myocutaneous Flaps

Hsu, Honda; Chien, Shu; Wang, Chien-Hsing; Cheng, Li-Fu; Lin, Chih‐Ming; Wu, Meng-Si; Huang, Chieh-Chi; Lee, Jiunn-Tat

doi:10.1097/sap.0b013e3182749d31

Cited by 13 publications

(5 citation statements)

References 24 publications

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“…It may be used for small defects as reported in case 2, but may also be used for extensive defects, as in case 1. While its foremost use is as a free flap, its use as a pedicled flap may also be unrivalled; the possibilities presented by pedicle size and length, the size of the flap that can be harvested, and the different components that can be included, as well as the fact that a reverse flap can be raised, make it a favourite reconstructive choice for defects within its area of reach (12,14). Gravvanis et al reported excellent blood flow in reverse ALT flaps they used for the coverage of knee and proximal leg defects (13).…”

Section: Discussionmentioning

confidence: 99%

Versatility of the Pedicled ALT Flap in Defect Reconstruction: Experience of a Unit in Rural Sub-Saharan African

Nthumba¹

2018

Ann Afr Surg.

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Background: The free anterolateral thigh flap with its large caliber vessels, a reliable skin territory and minimal donor site morbidity is the reconstructive surgeons' workhorse. The pedicled flap though not as popular, has been used extensively for the reconstruction of defects from the mid-leg to the epigastrium. The favorable profile of the anterolateral thigh flap, with minimal variability of its vascular anatomy and donor site complications is well described in most races; literature of its use in sub-Saharan Africa is scanty. Methods: The author describes the use of the anterolateral thigh flap in a series of 17 patients in a rural African hospital, illustrating its versatility as well as the complications associated with its use in this patient population. Results: Seventeen patients with

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Section: Discussionmentioning

confidence: 99%

Versatility of the Pedicled ALT Flap in Defect Reconstruction: Experience of a Unit in Rural Sub-Saharan African

Nthumba¹

2018

Ann Afr Surg.

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“…Although the tensor fascia lata (TFL) flap remains the workhorse flap for trochanteric region reconstruction due to its reliability and ease of harvest [2], it has significant shortcomings. In recent years, the pedicled anterolateral thigh (ALT) flap has be-come more popular, and it now has an established role in reconstruction of defects in the perineum, groin, anterior abdominal wall, and thigh [3][4][5][6][7]. However, few case series in the literature have reported utilizing the pedicled ALT flap for trochanteric pressure sore reconstruction [8][9][10][11].…”

Section: Introductionmentioning

confidence: 99%

“…come more popular, and it now has an established role in reconstruction of defects in the perineum, groin, anterior abdominal wall, and thigh [3][4][5][6][7]. However, few case series in the literature have reported utilizing the pedicled ALT flap for trochanteric pressure sore reconstruction [8][9][10][11].…”

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confidence: 99%

The pedicled anterolateral thigh flap for trochanteric pressure sore reconstruction: Technical notes to optimize surgical outcomes

Hifny

2021

Arch Plast Surg

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Background The pedicled anterolateral thigh (ALT) flap has become more popular for the reconstruction of soft-tissue defects in neighboring areas. Nonetheless, few studies in the literature have explored the use of this flap for trochanteric ulcer reconstruction. The aim of our study is to present the author’s experience of utilizing the ALT flap, with a focus on technical elements regarding the flap design and the tunneling method to maximize the reach of the flap.Methods The medical records of patients who received pedicled ALT flaps for the reconstruction of trochanteric pressure sores were retrospectively reviewed. The patients’ demographic data, operative details, and postoperative complications were evaluated.Results Between October 2018 and December 2019, 10 consecutive patients (age range, 13–45 years) underwent 11 pedicled ALT myocutaneous flaps for trochanteric pressure sore reconstruction. Each flap was designed around the most distal cutaneous perforator that was included in the proximal third of the skin paddle. The flaps ranged in size from 11×6 to 14×8 cm. The ALT flap was transposed through a lateral subcutaneous tunnel in five patients, while the open tunnel technique was used in six patients. All flaps survived, and no vascular compromise was observed.Conclusions The pedicled ALT flap is a safe and reliable option for reconstructing trochanteric pressure sores. An appropriate flap design and a good choice of the tunneling method are crucial for successful flap transposition.

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“…Song reported ALT flaps based on the blood supply from septocutaneous or musculocutaneous perforators from the lateral femoral circumflex artery or the profundus femoral artery. This flap has the advantages of a wide skin paddle, a long large caliber pedicle, possible simultaneous two-team approach(Hsu et al, 2012;Lee, St- Hilaire, Christy, Wise, & Rodriguez, 2010;LoGiudice et al, 2014). In addition, if the width of the donor site is less than 8 cm, primary closure is possible and the scar can be easily covered due to the nature of its location(Ali, Bluebond-Langner, Rodriguez, & Cheng, 2009).…”

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confidence: 99%

Extensive full thickness abdominal wall reconstruction using anterolateral thigh compound flap modifications

Eun

2019

Microsurgery

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Purpose Abdominal wall reconstruction is challenging, which demands adequate skin coverage and structural support. The anterolateral thigh (ALT) flap including fascial portion can be useful in such cases. Methods Retrospective chart review of five patients that underwent complex abdominal wall defects reconstruction with ALT free flaps with fascia lata was conducted. Patient age ranged from 49 to 69 years (average: 57.4). The etiology of defects was infected liposuction site, small bowel perforation, esophageal cancer, diverticulum perforation, and Hartmann operation. The average size of the defect was 17.4 × 10 cm (9 × 9 ~ 21 × 18). Single‐stage reconstruction using ALT flaps based on the lateral circumflex femoral artery was done in all patients. Exposed intestines were successfully covered and reinforced utilizing fascial component. Results The average size of the flap was 17.4 × 8 cm (9 × 9 cm ~25 × 10 cm). One partial flap necrosis, venous congestion, and infection occurred. These complications were treated successfully. During the follow‐up (12–96 months, mean: 63), all patients achieved functional stabilization and returned to normal activities. Conclusion ALT flap combined with its fascial component is useful for abdominal wall. It can be a reliable option in cases of intestinal exposure.

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Expanding the Applications of the Pedicled Anterolateral Thigh and Vastus Lateralis Myocutaneous Flaps

Cited by 13 publications

References 24 publications

Versatility of the Pedicled ALT Flap in Defect Reconstruction: Experience of a Unit in Rural Sub-Saharan African

Versatility of the Pedicled ALT Flap in Defect Reconstruction: Experience of a Unit in Rural Sub-Saharan African

The pedicled anterolateral thigh flap for trochanteric pressure sore reconstruction: Technical notes to optimize surgical outcomes

Extensive full thickness abdominal wall reconstruction using anterolateral thigh compound flap modifications

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