Versatility of antero-lateral thigh free flap in reconstruction of defects in different parts of body - our experience

Abstract

Extensive soft tissue defects pose a great deal of challenge to the reconstructive surgeon. The aim of this study is to analyze the outcome of free anterolateral thigh (ALT) flaps for soft tissue reconstruction of defects following tumor excision, trauma and post burn. A retrospective review of 19 patients undergoing ALT Flaps for various reasons from Dec 2018 to Jan 2021 was performed to determine perioperative factors, demographic profile, complications and outcomes. The mean age of the study population was 47.2 years. The male to female ratio was 2.16:1 (68.5 % male, 31.5% females). The etiology of soft tissue defect was post-tumor resection-47.36%, truam-36.8%, post burn reconstruction-10.5%. The defect sites were most commonly leg-31.5%, upper extremity-26.3%, buccal mucosa-15.7%, scalp-10.5%, tongue-10.5%, breast-5.2%. Flaps were harvested from right thigh in 52% of cases and left thigh in 58% of the cases. Donor site was closed primarily in 11 cases (57.8%), SSG coverage was done for 8 cases (42.8%). The minimum hospital stay post op was 12 days, maximum being 45 days. Postoperative complications were seen in 36.8% of the cases. Partial flap necrosis occurred in 3 cases (15.7%), complete necrosis in 1 case (5.2%), donor site morbidity was seen in 3 cases (15.7%). In the post-operative period hematoma and infection occurred in 3 cases. ALT Flap in experienced hands provide reliable coverage of large soft tissue defects with excellent aesthetic and functional outcomes with minimal donor site morbidity.