The clinical application and type of anterolateral thigh flap

Abstract

Objective To investigate the effect of anterolateral thigh flap for repairing soft tissue defects of extremities and the clinical meaning of blood vessel types. Methods From November, 2011 to December, 2014, 102 cases of limbs soft tissue defects were treated with anterolateral thigh flap, through retrospectively analyzed. Seventy-five cases for leg and ankle, 27 cases for forearm and hand. The wounds sized from 5.0 cm × 14.0 cm-14.0 cm × 36.0 cm. The type of blood vessel include type I, 90 cases (contain 21 flow-through anterolateral perforator thigh flaps) , type II, 8 cases, and type IIIa, 4 cases. All of this cases were applied with turbocharge. The flap area was 7.0 cm × 15.0 cm-7.5 cm × 28.0 cm. Flap combination tissues transplantation were 35 cases (contain latissimus dorsi muscle, second digiti pedis, free wrap-around flap, etc.) , 3 cases included 3 tissues. Simultaneously 9 cases were repairing for reconstruction circulation of extremities. Results Ninety-seven cases were survived completely, 2 flaps survived partially, mortification 3 cases. Finally, free skin grafting to repair wound surface. Sixty-two cases had a primary wound healing (stage I) , 24 cases had a delayed wound healing (stage Ⅱ). Three cases had infected, which had not be healed until 2-15 months after operation. Conclusion The method is definite effective for treatment of soft tissue defects of extremities. Anterolateral thigh flap can be incised in Ⅲ types, according to blood vessel. It is most clinical significant that the method of flap circulation establishment can alter the type of flap blood-supply. Key words: Anterolateral thigh perforator flap; Transplantation; Soft tissue defects; Extremity; Microsurgical operation