Use of Fascia Component of the Anterolateral Thigh Flap for Different Reconstructive Purposes

Abstract

The anterolateral thigh flap is commonly used for reconstruction of soft-tissue defects located at various sites of the body. This versatile flap offers many advantages to the reconstructive microsurgeons for the treatment of difficult defects. From 2000 to 2005, 70 anterolateral thigh flaps were transferred to reconstruct soft-tissue defects. We retrospectively reviewed these patients and found that the fascia lata component of the flap was used for different purposes in 19 patients. The fascia lata component of the flap was used for suspension of the flap in lip reconstruction in 12 patients, for reconstruction of dural defect in the scalp in 2 patients, for reconstruction of tendon defects in the forearm in 3 patients, and for reconstruction of fascia defect in the abdominal wall in the remaining 2. Complete loss of the flap was seen in an anterolateral thigh flap (5.2%) that was used for lower lip reconstruction. One flap necrosed partially (5.2%), and it was treated with surgical debridement and transposition of latissimus dorsi musculocutaneous flap. The objective of this study is to focus on the reliability of the fascial component of the anterolateral thigh flap. Although many authors have described other advantages of the anterolateral thigh flap extensively, this peculiarity has not been stressed adequately. Anterolateral thigh flap offers a thick and vascular fascial component with large amounts that can be used for different reconstructive purposes, and it should be taken into consideration as an important advantage of the flap, together with other well-known advantages.

Reconstruction of a full-thickness abdominal wall defect using an anterolateral thigh free flap

“…There are very few case reports in the literature describing the use of free flaps to reconstruct large full-thickness abdominal wall defects [19][20][21][22]. The LCFA-vl is a perforator flap [6]; i.e., the cutaneo-adipose layers, with or without underlying muscle and fascia, are vascularized by one or several perforating vascular pedicles.…”

“…This necessitates a delicate intramuscular dissection of these vessels. The fasciocutaneous LCVA-vl flap is fairly thin (2.6 cm on average) [24] and a large area up to 25 × 18 cm can be harvested with its underlying aponeurosis [22]. The length of the pedicle can vary from 10 to 18 cm [25,26] depending on the patient's anatomy and the dissection of the perforators; vessel caliber is usually greater than 2 mm which makes microsurgical anastomosis quite feasible.…”

Abdominal wall reconstruction using a combination of free tensor fasciae lata and anterolateral thigh myocutaneous flap: a prospective study in 16 patients

“…It eliminates the complications as well as intolerance to synthetic implants, rendering it a good replacement for the abdominal wall. Another frequently used flap is anterolateral thigh myocutaneous flap based on the lateral circumflex femoral artery/vastus lateralis musculo-fascial aponeurosis (LCFA-vl) first described by Song et al (5), and has been used with increasing frequency for reconstruction M A N U S C R I P T A C C E P T E D ACCEPTED MANUSCRIPT 3 combined free flaps to reconstruct massive full-thickness abdominal wall defects (7)(8)(9)(10).…”

Colgajo anterolateral del muslo: anatomía quirúrgica, técnica de disección y aplicaciones clínicas

“…Si el defecto se encuentra en el labio, la fascia lata del colgajo puede emplearse como cincha para obtener un labio inferior más continente (20).…”