Use of Anteromedial Thigh Flaps as an Alternative to Anterolateral Thigh Flaps for Reconstruction of Head and Neck Defects in Cancer Patients

Abstract

To determine whether anteromedial thigh (AMT) flaps are a good choice for reconstruction in cases in which no sizable skin perforator is found in anterolateral thigh (ALT) flap dissection or ALT flaps have been previously harvested. From February 2006 to August 2008, 17 free AMT flaps were used to reconstruct soft tissue defects of the head and neck. We recorded the age and sex of the patients, sites of primary tumor, tumor stage, size of defect, previous operative conditions, results of flap transfer, and donor-site complications. Of the 17 AMT flaps, 1 flap failed and 1 showed partial necrosis. Venous insufficiency developed in 2 cases, and the flaps were successfully salvaged in both the cases. The success rate was 94.1%. The AMT flaps were 6 to 20 cm long and 4 to 9 cm wide. The mean length of the pedicle was 7.5 ± 1.0 cm (range, 5-12 cm). Of the 17 donor sites, 6 were closed directly, 9 were closed using split-thickness skin grafts, and 2 were closed using full-thickness skin grafts. Complications and morbidity of the donor site were minimal. Cases in which no sizable perforator is found or an ALT flap has been previously harvested pose an aesthetic challenge, and an AMT flap is a good alternative for performing successful reconstruction in such cases.