Abstract
Primary closure of a large anterolateral thigh (ALT) flap donor site defect with the assistance of an external tissue expansion system is presented. The dimensions of this donor site (12 cm × 40 cm) and its percentage of leg circumference (34%) would make this site likely to require skin grafting or further flap coverage based on the results of previously published literature.
Highlights
The anterolateral thigh (ALT) flap has become a popular choice of reconstructive surgeons when soft tissues are required for a given defect
Additional reported complications of the utilization of skin grafts at ALT donor sites include the following: lack of durability, pain, contour deformity, and limited maneuverability from adhesions to underlying musculature [1,2,3,4,5,6]. These complications can essentially be negated through primary closure of the donor site, compartment syndrome has been reported as a complication of overly aggressive closure [6]
With regard to potential primary closure of the ALT donor site, several studies have been published to elucidate which defects are likely to necessitate a skin graft for closure. In their experience with 672 ALT flaps, Wei et al stated that 40% of their donor sites, often those with width greater than 6 to 9 cm, would require a skin graft [7]
Summary
The anterolateral thigh (ALT) flap has become a popular choice of reconstructive surgeons when soft tissues are required for a given defect. Additional reported complications of the utilization of skin grafts at ALT donor sites include the following: lack of durability, pain, contour deformity, and limited maneuverability from adhesions to underlying musculature [1,2,3,4,5,6]. These complications can essentially be negated through primary closure of the donor site, compartment syndrome has been reported as a complication of overly aggressive closure [6]. There have not been any published reports of the utilization of an external tissue expander in the closure of these donor sites
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