Proximally Based Anterolateral-Thigh (ALT) Flap for Knee Reconstruction: An Advancement Propeller Perforator Flap

Cadenelli, Pierfrancesco; Bordoni, Daniele; Radaelli, Stefano; Marchesi, Andrea

doi:10.1007/s00266-015-0536-2

Cited by 10 publications

(8 citation statements)

References 23 publications

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“…In patient with sarcoma, peritumor edema is an important complication. Similar case reported for anterior lateral thigh flap underwent wide-resection soft tissue sarcoma without skin grafting [5]. Also, reported cases of tumors resection then covered by propeller flap [6].…”

Section: Discussionsupporting

confidence: 57%

Propeller Flap in Patient with Ewing’s Sarcoma in Lower Limb: A Case Report Study

AlBahrani¹

2017

JCPCR

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Propeller flap is a standard procedure for lower limb reconstructing defect. Few cases of propeller flap used in sarcoma induced defect have been reported. Here we report a patient with Ewing's sarcoma who presented with left ankle mass.Following Doxorubicin/Cisplatin-Neoadjuvant the patient was admitted with swelling and biopsy confirmed poorly differentiated sarcoma. Per FNCLCC grading system for histologic type, MRI and cytogenetics, antitumor treatment of sarcoma was done, and patient underwent combined surgery for tumor resection and propeller flap was done.

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Section: Discussionsupporting

confidence: 57%

Propeller Flap in Patient with Ewing’s Sarcoma in Lower Limb: A Case Report Study

AlBahrani¹

2017

JCPCR

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“…; Cadenelli et al. ), the posterolateral thigh flap (Laitung, ) and the lateral supragenicular pedicle perforator flap (Spokevicius & Jankauskas, ; Taniguchi et al. ; Nguyen et al.…”

Section: Discussionmentioning

confidence: 99%

“…Especially the angiosome of the saphenous branch has frequently been described as the basis for free skin flaps, neurovascular free flaps, osteocutaneous flaps or reversed-flow flaps, especially due to its long pedicle Guan et al 1985;Koshima et al 1988;Torii et al 1989;Bertelli, 1992a,b;Ballmer & Masquelet, 1998;Karamursel & Celebioglu, 2006;Iorio et al 2012;Dai et al 2013). More recently, the SLGA has been reported as source vessel in descriptions of the anterolateral-thigh flapapart from the descending branch of the lateral circumflex femoral artery (Hayashi & Maruyama, 1990a;Yamada et al 2014;Cadenelli et al 2015), the posterolateral thigh flap (Laitung, 1989) and the lateral supragenicular pedicle perforator flap (Spokevicius & Jankauskas, 1995;Taniguchi et al 2009;Nguyen et al 2011).…”

Section: Discussionmentioning

confidence: 99%

Vascular coverage of the anterior knee region – an anatomical study

2019

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Descriptions of vessel angiosomes or perforasomes throughout the human body are quite frequent, and led to the development of flaps nowadays commonly used to surgically cover skin and soft tissue defects. In these procedures, the surgeon requires a profound anatomical knowledge of the respective blood vessels and the extent of the perfused area to define the size of the graft. In the region of the knee joint, descriptions of flaps based on the superior lateral genicular artery and descending genicular artery are quite frequent. In contrast, information regarding other popliteal branches is scarce or non‐existent. The aim of this study was to provide a concise and complete overview on the extent and variability of the perforator angiosomes of the femoral and popliteal arteries in the anterior knee region. Twenty lower extremities were dissected, the respective perforators identified and perfused with dye. All resulting angiosomes were marked and documented. A total of 84 angiosomes were identified in all specimens, with an average of 4.2 (3–6) angiosomes per specimen. The average size of the angiosomes was 97.04 ± 72.30 cm 2 (8.61–360.41 cm 2 ), their source vessels had an average diameter of 1.42 ± 0.54 mm (0.60–3.25 mm). The complex and highly variable distribution of perforator angiosomes of the anterior knee region and especially of its less frequently investigated distal part was demonstrated. Based on these results, the planning of existing perforator flaps in this region and the development of flaps including the inferior medial or inferior lateral genicular arteries may be facilitated.

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“…[16] 2016 Knee Lateral genicular artery flap Cadenelli et al . [19] 2015 Knee Advancement propeller perforator ALT Baxter et al . [20] 2007 Knee Gastrocnemius…”

Section: Thighmentioning

confidence: 99%

“…However more complex defects may require the use of free tissue transfer. In these cases the deep-seated recipient popliteal vessels of the knee can make microvascular anastomosis difficult [19] , an autologous vein graft loop can be used and the distal SFA and SFV can be used as recipient vessels if there is an extended field of neoadjuvant radiation [14] . Multiple donor sites have been successful used in free flap coverage of knee defects.…”

Section: Kneementioning

confidence: 99%

Complex reconstruction of the lower extremity following sarcoma resection: a literature review

Azadgoli¹,

Carre²,

Perrault³

et al. 2018

PAR

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While amputation was traditionally the only option available for patients with sarcomas of the extremities, chemotherapy, radiation, and advances in microsurgical technique have allowed many patients to undergo limb-salvaging procedures. Given the low incidence and heterogeneity of these tumors, there is currently no standard treatment algorithm for limb reconstruction after large sarcoma resection. Thus, we systematically reviewed the various types of free tissue transfer used for the reconstruction of lower limbs after sarcoma resection. Techniques were described based on anatomic location. This literature review supports free tissue transfer as a safe and acceptable modality for reconstruction after sarcoma resection of the lower limb. It allows for the application of healthy vascularized tissue to the defect while also providing freedom of flap positioning. Flap choice is dependent on tumor and defect size, tissue type and function, as well as donor site availability.

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Proximally Based Anterolateral-Thigh (ALT) Flap for Knee Reconstruction: An Advancement Propeller Perforator Flap

Abstract: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Cited by 10 publications

References 23 publications

Propeller Flap in Patient with Ewing’s Sarcoma in Lower Limb: A Case Report Study

Propeller Flap in Patient with Ewing’s Sarcoma in Lower Limb: A Case Report Study

Vascular coverage of the anterior knee region – an anatomical study

Complex reconstruction of the lower extremity following sarcoma resection: a literature review

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