Zdravniški Vestnik (May 2006)
Free anterolateral thigh flap
Abstract
Background: For reconstruction of soft tissue defects in reconstructive microsurgery after ablation of tumors or following trauma flaps having following characteristics are being searched for: large surface, long vascular pedicle with large diameter of vessels, possibility of transfer of multiple tissues (skin, muscle, fascia, tendons, bone) on the same nutrient vessels, independent movement of different components of the flap in space, harvesting in supine position and primary donor site closure. Many of these characteristics are being met by the radial forearm flap however its main dissadvantage remains donor site closure by split thickness skin grafts. This can be avoided by the use of the anterolateral thigh (ALT) flap.Methods: The ALT flap is raised, like other perforator flaps, arround the septocutaneous perforator, which is located by Doppler ultrasound at midpoint on the line connecting anterior superior iliac spine and upper lateral border of patella or arround musculocutaneous perforators. Vascular pedicle can be made longer by harvesting of the descendent branch of the lateral circomflex femoral artery.Results: We report the first successfull free ALT flap transfer for soft tissue reconstruction of oral cavity and cheek after ablation of a recurrency of a malignant tumor in Slovenia.Conclusions: Because of its proprieties the ALT flap is suitable for reconstruction of defects on head and neck and extremities following tumor ablation or trauma. Because of its advantages it will replace also in our country the radial forearm flap which is the most popular flap in Slovenija for these indications.
