Free anterolateral thigh flap in head and neck reconstruction

Abstract

Objectives The aim of this randomized prospective trial was to evaluate indications, advantages, disadvantages, and complications of the usage of anterolateral thigh (ALT) flap as a free flap in head and neck reconstruction. Background Reconstruction of the head and neck continues to pose a formidable challenge for maxillofacial and plastic surgeons.The free ALT flap has emerged as a popular option for the reconstruction of head and neck defects. The present study evaluates the usage of free ALT flap in head and neck reconstruction. Materials and methods From January 2012 to January 2013, patients who had extensive soft-tissue defect in the head and neck and had been reconstructed by free ALT flap have been reported. Flap data (type, length, and width), duration of flap elevation, donor-site morbidity, postoperative complications, and follow-up data including aesthetic and functional outcome were recorded. Results The mean total harvest time of the flap was 113 min, the mean skin paddle width in our study was 10 cm (range, 7-15 cm), and length was 13 cm (range, 10-16 cm). The donor site in all cases had been closed directly. Failure of microvascular anastomosis occurred in one flap (from a total of three cases in the study), although no significant donor morbidity has been reported. Conclusion The ALT flap can be reliably harvested without incurring serious donor morbidity. It possesses workhorse attributes (no repositioning, remote from defect, and long pedicle) and is extremely versatile, making it ideal for the heterogeneous group of extensive soft-tissue head and neck defects.