Free Anterolateral Thigh Flap

Abstract

The free anterolateral thigh flap, based on the descending or transverse branch of lateral circumflex femoral artery (LCFA), is first described by Song et al in 1984. THe perforators of the transverse or descending branch of the LCFA, either septocutaneous or musculocutaneous, supply a very large skin territory over anterolateral aspect of thigh. The flap can be designed as a neurosensory one by including branches of the lateral femoral cutaneous nerve. If a longer pedicle is needed for bypassing trauma zone or radiated zone, reverse flow pedicle can be harvested by dissecting distally down to near the knee joint region. In obese patients, the flap can be made thin by removing most of the subcutaneous fat (thinning procedure). Since May 1996 to May 1997, we carried out 25 transfers of the anterolateral thigh flaps with satisfactory results. The overall success rate in our series is 92%. It was used for the reconstruction over head and neck region, upper extremity, and lower extremity. It is particularly useful for lower extremity reconstruction because both donor site and recipient site can be confined to the lower extremity.