Commentary on the paper “Cervicothoracic reconstruction with an anteromedial thigh flap: A novel flap concept”

Abstract

This is a commentary on the paper “Cervicothoracic reconstruction with an anteromedial thigh flap: a novel flap concept”. It is an excellent case. The method to use a segment of SFA to replace the carotid artery is great and the defect of SFA could be reconstructed with a Gore-Tex prosthesis. This method has the following advantages: (1) When the cancer has invaded the carotid artery with encasement, this method provides a more radical way of ablating the malignancy. (2) In the presence of potential infection, this method provides an autogenous tissue graft for the carotid artery instead of an artificial graft which has more chance of infection and blow-out. (3) In addition to a segment of SFA, it carries soft tissue and skin for simultaneous reconstruction of defects of large vessel and soft tissue. However, the author should be careful about the anatomical variations of perforators at the medial thigh region. Secondly, the territory of the skin paddle is still not clearly defined with individual difference, so that partial loss can happen if the skin paddle is too large. Even CT angiography has proved the presence of perforators, the area of complete survival for medial thigh flap is not so clear as the anterolateral thigh flap. The venous return of the flap should also be watched for a large anteromedial thigh flap. I would suggest using a smaller anteromedial