Lateral Thigh Free Flap With Flow-Through Vascular Pedicle

Abstract

The lateral thigh flap based on the second and third perforator of profunda femoris vessel has not become very popular. We describe a technique of flow-through pedicle for this flap. The flow-through technique makes this flap very simple to transfer. The flap was used successfully in 6 cases for reconstruction for defects in the leg and forearm. The flow-through pedicle is ideal for lower limb reconstruction. The anastomosis becomes very easy and safe, even if the recipient vessels are deep in the intermuscular septum. We had no flap failures. The flap has a very predictable anatomy. Large flaps from anteriolateral and posterior part of midthigh can be safely elevated. The flap can meet a variety of requirements as it can be thin skin-alone flap, a fasciocutaneous flap, or even a musculocutaneous flap. A simple pinch test gives a fair idea of expected flap thickness. The dissection requires strong retraction of the anterior thigh muscles, but the dissection is safe and simple. The donor-site morbidity is very minimal.

Early Mobilization after Free-flap Transfer to the Lower Extremities

“…14–17 In contrast, we used flow-through arterial anastomosis in this study to improve the patency rate and to stabilize the circulation of the flap, even when reconstructing recipient-artery continuity was unnecessary. We have previously demonstrated that flow-through arterial anastomosis has a higher patency rate than end-to-end and end-to-side anastomoses and increases the flow rate through the anastomotic site.…”

Use of Flow-Through Anterolateral Thigh Perforator Flaps in Reconstruction of Complex Extremity Defects

“…The flow-through flap is potentially the best choice in these situations, as it can simultaneously provide arterial reconstruction and soft-tissue coverage. [7][8][9][10][11][12][13][14][15][16] In our series, two flow-through ALTP flaps were used for simultaneous soft-tissue and vascular gap reconstruction (cases 2 and 3), and the flaps and distal limbs both survived postoperatively. In this situation, the pedicle of the flow-through flap must be interposed between two ends of the recipient vessel to bridge the vascular gap.…”

Thumb reconstruction via a pedicled flap based on the superficial palmar branch of the radial artery from the wrist crease area

“…Therefore, the severed phalanx can be well supplied by this flap in a flowthrough manner. 25 This island flap is especially suitable for the restoration of blood circulation in thumbs with proximal digital artery defects. In addition, this flap can cover softtissue defects.…”