Use of the Anterolateral Thigh Free Flap for Upper-Extremity Reconstruction

Wang, Howard T.; Fletcher, James; Erdmann, Detlev; Levin, L. Scott

doi:10.1016/j.jhsa.2005.03.016

Cited by 57 publications

(60 citation statements)

References 11 publications

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“…Most authors quote a maximum width for a primary closure of the donor site of 8 cm to 10 cm (3,7,25,(35)(36)(37)39,42); however, wider defects have been closed, such as a reported 12 cm defect in a patient with a relatively large thigh circumference secondary to a high body mass index (3). A primarily closed donor site may result in a long scar, but it is usually more aesthetically pleasing than when closed with a skin graft, which is commonly done if a donor site defect is too wide to safely close without significant tension (32,39).…”

Section: Skin Graftsmentioning

confidence: 99%

“…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%

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A systematic review of anterolateral thigh flap donor site morbidity

Collins¹,

Ayeni²

2012

J Plastic Surgery

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Section: Skin Graftsmentioning

confidence: 99%

mentioning

confidence: 99%

A systematic review of anterolateral thigh flap donor site morbidity

Collins¹,

Ayeni²

2012

J Plastic Surgery

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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%

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 ALT flap was first reported in 1984 [36], and in recent years has become one of the most commonly used flaps in reconstructive microsurgery, especially in head and neck and extremity reconstruction [30]. The ALT flap is eminently suitable for upper extremity reconstruction as it has a large available surface area, long vascular pedicle (from the descending branch of the lateral circumflex femoral artery), can be thinned providing good contours [37,38], can be neurotized for protective sensibility [39] and the patient can stay supine during harvest [40]. Reliable and satisfactory results for upper limb reconstruction (Figure 3) have been reported in several series worldwide [41][42][43].…”

Section: Free Fasciocutaneous Flapsmentioning

confidence: 99%

Microvascular Reconstruction of the Upper Extremity

Whitaker

Josty

van-Aalst

et al. 2007

Eur J Trauma Emerg Surg

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Where possible, the best results may be achieved by reattaching the amputated original tissues (microsurgical replantation). In noninfected, uncontaminated traumatic injuries resulting in composite soft tissue defects, Early free flap reconstruction of the upper extremities has important advantages over delayed (72 h-3 months) or late wound closure (3 months-2 years). In recent years, thin, pliable, and versatile fasciocutaneous flaps such as the anterolateral thigh (ALT) and lateral arm (LA) free flaps have been increasingly used with great success to reconstruct the upper extremity. The use of "spare parts" and functional reconstructions using osteomyocutaneous free flaps or toe to thumb transfers complete the armamentarium of the upper limb reconstructive microsurgeon.

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Use of the Anterolateral Thigh Free Flap for Upper-Extremity Reconstruction

Cited by 57 publications

References 11 publications

A systematic review of anterolateral thigh flap donor site morbidity

A systematic review of anterolateral thigh flap donor site morbidity

Customized reconstruction with the free anterolateral thigh perforator flap

Microvascular Reconstruction of the Upper Extremity

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