Buried anterolateral thigh flap for pharyngoesophageal reconstruction: Our method for monitoring

Abstract

A noninvasive method for monitoring in cases of pharyngoesophageal defects reconstruction with the anterolateral thigh flap is presented. Seventeen patients underwent reconstruction from 2005 to 2007. In 16 patients, the distal stump of the descending branch of lateral circumflex femoral artery (LCFA) was left on the skin surface covered with a transparent film dressing and monitoring was performed by direct observation of the pulsation. In the 17th patient, the pedicle emerged from the transverse branch of the LCFA and dissection of the distal stump for monitoring was impossible; therefore, he was excluded from the study. Cessation of the pulsation of the stump was noticed immediately postoperatively in 1 patient because of occlusion of the arterial anastomosis and in a second case 15 hours postoperatively due to a neck hematoma that caused collapse of the vein of the pedicle. Both flaps were salvaged. The proposed method of monitoring is simple, reliable, costless, and easily interpreted by the nursing staff.