The anterolateral thigh flap; variations in its vascular pedicle

The Role of the Anterolateral Thigh Flap for Pharyngoesophageal Reconstruction

“…Finally, the skin paddle can be designed considerably larger than the RFFF. Koshima et al 4 originally reported a maximum dimension of 25 ϫ 18 cm. Recently, Yildirim et al 5 reported a maximum dimension of 20ϫ 26 cm.…”

A systematic review of anterolateral thigh flap donor site morbidity

“…With regard to the pedicle, the ALT flap has a long pedicle with good calibre, which can be located and dissected out before committing to the final flap design. Furthermore, there is the potential for converting to another type of flap, such as a tensor fascia lata flap, with only minor changes to the skin paddle (47) if needed due to anatomical variation in the vascular pedicle. Flap design benefits include a large and pliable skin territory with the ability to design more than one skin paddle depending on the perforator anatomy; the ability to modify flap thickness by elevating a thin fasciocutaneous flap, or providing bulk by incorporating muscle (vastus lateralis), or further thinning the flap by removal of the deep fascia and subcutaneous fat tissues; versatility, because it can be customized with the addition of bone (ileum), tendon, fascia (tensor fascia lata) or nerve (lateral femoral cutaneous); and the ability to tailor the flap as a pedicle or free flap, using vessels as a single anastomosis or as flow-through.…”

A Case of Harvesting Anterolateral Thigh Flaps Twice from the Ipsilateral Thigh of a Single Patient in Separate Operations

“…In such cases, flaps are harvested from different donor sites of the same patient in each operation. There are several skin perforators arising from the descending branch of the lateral femoral circumflex artery [2]. It is possible to elevate a large flap and two skin paddle flaps by utilizing two of these skin perforators [1].…”