The free anterolateral thigh musculocutaneous flap for head and neck reconstruction: One surgeon's experience in 92 cases

Bianchi, Bernardo; Ferri, Andrea; Ferrari, Silvano; Copelli, Chiara; Boni, Pietro; Ferri, Teore; Sesenna, Enrico

doi:10.1002/micr.20952

Cited by 58 publications

(57 citation statements)

References 31 publications

(27 reference statements)

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“…The anterolateral thigh flap (ALT) is another workhorse flap for soft‐tissue reconstructions in the lower extremities. The ALT flap can provide a large skin paddle nourished by a long and large‐caliber pedicle . However, all free flaps have the common drawback of the difficulty of choosing the recipient vessels because of the poor local wound condition in the lower extremity .…”

Section: Discussionmentioning

confidence: 99%

Distally based saphenous neurocutaneous perforator flap combined with vac therapy for soft tissue reconstruction and hardware salvage in the lower extremities

et al. 2013

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The complex wound with the exposed hardware and infection is one of the common complications after the internal fixation of the tibia fracture. The salvage of hardware and reconstruction of soft tissue defect remain challenging. In this report, we presented our experience on the use of the distally based saphenous neurocutaneous perforator flap combined with vacuum-assisted closure (VAC) therapy for the coverage of the soft tissue defect and the exposed hardware in the lower extremity with fracture. Between January 2008 and July 2010, seven patients underwent the VAC therapy followed by transferring a reversed saphenous neurocutaneous perforator flap for reconstruction of the wound with exposed hardware around the distal tibia. The sizes of the flaps ranged from 6 × 3 cm to 15 × 6 cm. Six flaps survived completely. Partial necrosis occurred in one patient. There were no other complications of repair and donor sites. Bone healing was achieved in all patients. In conclusion, the reversed saphenous neurocutaneous perfortor flaps combined with the VAC therapy might be one of the options to cover the complex wound with exposed hardware in the lower extremities.

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Section: Discussionmentioning

confidence: 99%

Distally based saphenous neurocutaneous perforator flap combined with vac therapy for soft tissue reconstruction and hardware salvage in the lower extremities

et al. 2013

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“…Similar to our results, Baek et al [14] and Smith et al [15] reported that most complications were venous thrombosis and congestion. Bianchi et al [16] and Kesting et al [17] reported several advantages of the anterolateral thigh flap for head and neck defects, including versatility, short harvesting time, and donor site morbidity. However, Kesting et al [17] reported that intra-operative arterial spasms occurred more often in the case of the ALT free flap than in the case of RFFF and that venous congestion was the most frequent complication in the case of the RFFF.…”

Section: Discussionmentioning

confidence: 99%

Free Flap Reconstruction of Head and Neck Defects after Oncologic Ablation: One Surgeon's Outcomes in 42 Cases

Lim

Kim

et al. 2014

Arch Plast Surg

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BackgroundFree flap surgery for head and neck defects has gained popularity as an advanced microvascular surgical technique. The aims of this study are first, to determine whether the known risk factors such as comorbidity, tobacco use, obesity, and radiation increase the complications of a free flap transfer, and second, to identify the incidence of complications in a radial forearm free flap and an anterolateral thigh perforator flap.MethodsWe reviewed the medical records of patients with head and neck cancer who underwent reconstruction with free flap between May 1994 and May 2012 at our department of plastic and reconstructive surgery.ResultsThe patients included 36 men and 6 women, with a mean age of 59.38 years. The most common primary tumor site was the tongue (38%). The most commonly used free flap was the radial forearm free flap (57%), followed by the anterolateral thigh perforator free flap (22%). There was no occurrence of free flap failure. In this study, risk factors of the patients did not increase the occurrence of complications. In addition, no statistically significant differences in complications were observed between the radial forearm free flap and anterolateral thigh perforator free flap.ConclusionsWe could conclude that the risk factors of the patient did not increase the complications of a free flap transfer. Therefore, the risk factors of patients are no longer a negative factor for a free flap transfer.

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“…However, exposure of the donor site leading to considerable donor site morbidity has led surgeons to seek alternative solutions. The anterolateral thigh (ALT) flap, introduced by Song [6] and popularized by Wei [7,8], who considered it to be the ideal skin flap, is used by many teams for oropharyngeal reconstruction [2,9,10]. The thoracodorsal artery perforator (TDAP) flap, described in 1995 by Angrigiani et al [11], presents identical plastic qualities to those of the ALT, allowing it to be used in the oropharynx.…”

Section: Introductionmentioning

confidence: 98%

“…Resection of a cancer involving the lateral or superior wall of the oropharynx can lead to disorders of nose breathing, nasal regurgitation while feeding and hypernasal speech. Oropharyngeal reconstructions are designed to palliate these defects and numerous techniques have been proposed [1][2][3]. The radial forearm flap, described by Yang [4] and Song [5], due to its thin skin paddle, ease of dissection, the length of its pedicle and the calibre of its vessels, is the flap of choice for these reconstructions.…”

Section: Introductionmentioning

confidence: 99%

Velopharyngeal function after free thoracodorsal artery perforator flap in lateral and superior oropharyngeal cancer

Bach

Wagner

Pigot

et al. 2014

Eur Arch Otorhinolaryngol

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The purpose of this study was to report our experience with the free thoracodorsal artery perforator flap for reconstruction of the oropharynx and soft palate in head and neck cancer using a retrospective review of the medical charts of all patients undergoing oropharyngeal reconstruction by free thoracodorsal artery perforator flap during the same procedure as cancer resection between January 2011 and April 2013. Evaluation of speech, feeding and the presence of nasal emissions was performed 6 months after treatment in accordance with the Declaration of Helsinki. Nine patients were evaluated. Clear understanding of the patient was reported by the family and the examiner for seven patients, while understanding difficulties were reported for two patients (1 case of flap dehiscence and 1 technical error of flap fixation). The results indicated that, due to its complex anatomy and function, reconstruction of the soft palate remains a delicate procedure. The free thoracodorsal artery perforator flap allows functional soft palate reconstruction, while limiting donor site morbidity.

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The free anterolateral thigh musculocutaneous flap for head and neck reconstruction: One surgeon's experience in 92 cases

Cited by 58 publications

References 31 publications

Distally based saphenous neurocutaneous perforator flap combined with vac therapy for soft tissue reconstruction and hardware salvage in the lower extremities

Distally based saphenous neurocutaneous perforator flap combined with vac therapy for soft tissue reconstruction and hardware salvage in the lower extremities

Free Flap Reconstruction of Head and Neck Defects after Oncologic Ablation: One Surgeon's Outcomes in 42 Cases

Velopharyngeal function after free thoracodorsal artery perforator flap in lateral and superior oropharyngeal cancer

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