Revista Brasileira de Cirurgia Plástica (Dec 2018)

Reverse anterolateral thigh flap: a reconstruction option for the lower limbs

  • Guataçara Schenfelder Salles-Junior,
  • Renato da Silva Freitas,
  • Jean Raitz Novais,
  • Andre Gustavo Maschio,
  • Dayane Raquel Paula,
  • Renata Fernanda Ramos Mascante,
  • Victor Rodamilans Sanjuan,
  • Andre Bilieri Pazio

DOI
https://doi.org/10.5935/2177-1235.2018RBCP0170
Journal volume & issue
Vol. 33, no. 04
pp. 493 – 500

Abstract

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Introduction: Cutaneous and soft tissue reconstruction in the region around the knee is often challenging for the plastic surgeon and aimed at providing good knee joint function with acceptable aesthetic appearance. Surgical planning requires considering the simplest technique that leads to wound closure, with minimal morbidity in the donor area. The literature has reported only few cases of the use of the reverse anterolateral (ALT) flap for defects in the popliteal fossa, knee, and leg proximal portion. The objective is to describe a series of cases of patients who underwent reconstruction with a reverse ALT flap for wounds in the popliteal fossa, knee, and upper third of the leg. Methods: Among four patients, three received popliteal fossa reconstructions and one received knee and leg proximal third reconstructions. All the patients underwent wound/tumor extensive resection, dissection of the reverse ALT flap, and transposition to the defect. Results: During follow-up for 2 to 18 months, minimal morbidity was observed in the donor area, with a total coverage of the defect, optimal functional result of the affected limb, and good aesthetic result. Only one case had a partial necrosis (15%) of the flap due to hematoma and pedicle compression. In the other patients, no evidence of flap failure, dehiscence, seroma, or infection were found. Conclusion: The reverse ALT flap was a viable option, presenting good functional and aesthetic results for cutaneous and soft tissue reconstructions in the popliteal fossa, knee, and upper third of the leg.

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