The anterolateral thigh as a universal donor site for soft tissue reconstruction in maxillofacial surgery

Wolff, Klaus‐Dietrich; Kesting, Marco; Thurmüller, Petra; Böckmann, Roland; Hölzle, Frank

doi:10.1016/j.jcms.2006.04.002

Cited by 55 publications

(40 citation statements)

References 20 publications

(27 reference statements)

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“…T he anterolateral thigh (ALT) flap, first described as a septocutaneous perforator-based flap by Song et al (1) in 1984, has recently gained popularity and has become an important option for reconstruction of multiple anatomical locations such as the head and neck (3)(4)(5)(6)(7)9,10,(12)(13)(14)16,(18)(19)(20)(21)(22)(23)(25)(26)(27)(28)(29)(30)32,34,36,38,39,(41)(42)(43), upper (15)(16)(17)(18)(19)26,32,35,37,38,42) and lower (8,(16)(17)(18)(19)22,24,…”

mentioning

confidence: 99%

A systematic review of anterolateral thigh flap donor site morbidity

Collins¹,

Ayeni²

2012

J Plastic Surgery

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confidence: 99%

A systematic review of anterolateral thigh flap donor site morbidity

Collins¹,

Ayeni²

2012

J Plastic Surgery

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“…Since Song et al reported the first use of an anterolateral thigh (ALT) flap as a septocutaneous flap in 1984, 6 the versatile ALT flap has been widely used in the reconstruction of various defects of the head and neck 7,8 facial contour, extremities, flank, and perineum. Published reports indicate that ALT flaps based on the same blood supply include perforator-based ultrathin skin flaps, deepithelialized flaps, myocutaneous vastus lateralis flaps, flow-through flaps, and extensive chimeric flaps that include parts of the surrounding muscles and even segments of the iliac crest.…”

mentioning

confidence: 99%

Anterolateral thigh adipofascial flap for the restoration of facial contour deformities

Jin¹,

Teng²,

Xu³

et al. 2010

Microsurgery

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From January 2000 to May 2008, 50 patients with facial contour deformities underwent soft tissue augmentation with 51 anterolateral thigh (ALT) adipofascial flaps. Fifty flaps survived with no complications; partial fat necrosis occurred in one flap. Mean follow-up was 16 months. Flaps ranged from 10 x 6 cm to 20 x 12 cm. Perforators were found in 50 flaps, 43 musculocutaneous perforators (84.3%) and 7 septocutaneous perforators (13.7%), with a mean of 2.5 perforators per flap. In one flap (2.0%), no perforator was found. In this case, we used an anteromedial thigh adipofascial flap using the medial branch of the descending branch of lateral circumflex femoral artery as the vascular pedicle. Relatively symmetric facial contour was achieved in 20 cases. In 30 cases, adjunctive procedures including flap debulking, fat injection, and resuspension were necessary, and 23 patients achieved satisfactory outcomes. We conclude that the ALT adipofascial flap can be successfully elevated and transplanted for the correction of soft tissue facial defects. This flap can provide tissue to fill large defects, and posses the qualities of pliability, an excellent blood supply, ease of suspension and fixation, and minimal morbidity at the donor site.

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“…4,[6][7][8][9][10][13][14][15]17,19,[32][33][34][35][36]38 It sends perforators through the septum between the vastus lateralis and the rectus femoris or through the vastus lateralis muscle and supplies a large skin flap on the anterolateral aspect of the thigh. If a visible septocutaneous perforator is found, the flap can be harvested as a septocutaneous flap.…”

Section: Discussionmentioning

confidence: 99%

“…7,22,23 Advantages of the free ALT flap, such as a long pedicle, reliable anatomy, [24][25][26][27][28][29][30][31] suitable vessel diameter, the availability of different tissues with large amounts of skin, skin-to-skin closure, its adaptability as a sensate and/or compound (composite and combined) flap, 9 adaptable volume and thickness, 34 no repositioning of the patient during operation and simultaneously working in two teams, and good esthetic outcome, are well known. [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][32][33][34][35][36] Disadvantages such as challenging dissection of musculocutaneous perforators with a prolonged operation time and unsatisfactorily esthetic outcome if the donor site has to be skin-grafted were taken deliberately into consideration.…”

Section: Discussionmentioning

confidence: 99%

“…[4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20] Similar to the well-recognized donor site of the subscapular artery system, 21 the lateral circumflex femoral artery (LCFA) system with its main transverse and descending branches offers multiple possibilities for the reconstruction of complex three-dimensional defects. 7,22,23 Advantages of the free ALT flap, such as a long pedicle, reliable anatomy, [24][25][26][27][28][29][30][31] suitable vessel diameter, the availability of different tissues with large amounts of skin, skin-to-skin closure, its adaptability as a sensate and/or compound (composite and combined) flap, 9 adaptable volume and thickness, no repositioning of the patient during operation and simultaneously working in two teams and good esthetic outcome, are well known [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18]…”

mentioning

confidence: 99%

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Customized reconstruction with the free anterolateral thigh perforator flap

et al. 2008

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From April of 2003 through September of 2006, 70 free anterolateral thigh (ALT) flaps were transferred for reconstructing soft-tissue defects. The overall success rate was 96%. Among 70 free ALT flaps, 11 were elevated as cutaneous ALT septocutaneous vessel flaps. Fifty-seven were harvested as cutaneous ALT myocutaneous "true" perforator flaps. Two flaps were used as fasciocutaneous perforator flaps based on independent skin vessels. Fifty-four ALT flaps were used for lower extremity reconstruction, 11 flaps were used for upper extremity reconstruction, 3 flaps were used for trunk reconstruction, and 1 flap was used for head and neck reconstruction. Total flap failure occurred in 3 patients (4.28% of the flaps), and partial failure occurred in 5 patients (7.14% of the flaps). The three flaps that failed completely were reconstructed with a free radial forearm flap, a latissimus dorsi flap and skin grafting, respectively. Among the five flaps that failed partially, three were reconstructed with skin grafting, one with a sural flap, and one with primary closure. The free ALT flap has become the workhorse for covering defects in most clinical situations in our center. It is a reliable flap with consistent anatomy and a long, constant pedicle diameter. Its versatility, in which thickness and volume can be adjusted, leads to a perfect match for customized reconstruction of complex defects.

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The anterolateral thigh as a universal donor site for soft tissue reconstruction in maxillofacial surgery

Cited by 55 publications

References 20 publications

A systematic review of anterolateral thigh flap donor site morbidity

A systematic review of anterolateral thigh flap donor site morbidity

Anterolateral thigh adipofascial flap for the restoration of facial contour deformities

Customized reconstruction with the free anterolateral thigh perforator flap

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