Anterolateral thigh perforator flap without fascia lata for repair of soft tissue defects of the extremities

Abstract

Objective To evaluate the clinical effects of transferring anterolateral thigh perforator flap (ALTP flap) without fascia lata for repairing soft tissue defects of the extremities. Methods Between November 2014 and April 2016, 13 cases of soft tissue defects of the extremities were treated by ALTP flap transfer without including the fascia lata. The area of flaps ranged from 12 cm×5 cm to 33 cm×11 cm. Combined use of computed tomography angiography (CTA) and color Doppler sonography (CDS) preoperatively located the perforators. The donor site was primarily closed in 11 cases, while full thickness skin graft was needed in 2 cases. A plaster cast was applied in all the patients for postoperative immobilization. Results Vascular crisis occurred in one flap, which survived completely after successful vessel exploration and re-anastomosis. Distal skin necrosis of 5 cm occurred in another flap, which was healed after skin grafting. The rest of the flaps survived uneventfully. The donor sites achieved primary healing in 12 cases, whereas one case had skin graft necrosis and wound healing after dressing change. All the patients were follow-up for 3 to 17 months, with an average of 7.7 months. Only 2 cases needed secondary debulking of the flap. Conclusion Anterolateral thigh perforator flap without fascia lata is a suitable flap for repairing soft tissue defects of the extremities. It has high survival rate, satisfactory appearance, and low donor site morbidities. Key words: Surgical flaps; Extremities; Soft-tissue defects; Anterolateral thigh perforator