Anatomy Of Anterolateral Thigh Flap Research Articles

Reseach development of vascular anatomy and preoperative design technology of anterolateral thigh flap

?To summarize the present status and progress of vascular anatomy and preoperative design technology of the anterolateral thigh flap. ?The relative researches focused on vascular anatomy and preoperative design technology of the anterolateral thigh flap were extensively reviewed, analyzed, and summarized. ?Vascular anatomy of the anterolateral thigh flap has been reported by numerous researchers, but perforators' location, origin, course, and the variation of the quantity have been emphasized. Meanwhile, the variation of descending branch, oblique branch, and lateral circumflex femoral artery has also been widely reported. Preoperative design technology of the anterolateral thigh flap includes hand-held Doppler, Color Doppler, CT angiography (CTA), magnetic resonance angiography, digital subtraction angiography, and digital technology, among which the hand-held Doppler is most widely used, and CTA is the most ideal, but each method has its own advantages and disadvantages. ?There is multiple variation of vascular anatomy of the anterolateral thigh flap. Though all kinds of preoperative design technologies can offer strong support to operation of anterolateral thigh flap, a simple, quick, precise, and noninvasive technology is the direction of further research.

Vascular Anatomy of Anterolateral Thigh Flap

To understand the vascular anatomy of the anterolateral thigh (ALT) free flap. To anatomically determine whether including a 2-cm cuff of vastus lateralis muscle (VLM) incorporates musculocutaneous perforators in the harvest of the ALT free flap. Anatomic study on human cadavers. Twenty-seven cadaver thighs were dissected. Musculocutaneous perforators from the vascular pedicle of the ALT free flap were identified. The distance from the anterior border of the VLM to the point where perforators entered the muscle was measured. An average of four musculocutaneous perforators to the ALT free flap were identified per thigh. The distance from the anterior border of the VLM to the point where perforators entered the muscle ranged from 0.1 to 7 cm, with the mean distance being 1.80 cm. Sixty-four percent of perforators entered the VLM within 2 cm of the muscle's anterior border. At least one perforator entered the VLM within 2 cm of the muscle's anterior border per thigh. Most musculocutaneous perforators to the ALT free flap enter the VLM within 2 cm of the muscle's anterior border, thus providing for an anatomic basis for including a 2 cm cuff of VLM when harvesting the ALT free flap. By including a 2 cm cuff of VLM, tedious dissection of individual musculocutaneous perforators is unnecessary, thereby increasing the ease of dissection and expediting the harvest of the ALT free flap.

Variation in the vascular anatomy of anterolateral thigh flap and its management

The anterolateral thigh flap is one of the well-known flaps. Various types of tissues can be incorporated into this flap and can be used to reconstruct defects from head to toe. Its variable vascular anatomy is well known. We encountered two vessels of good caliber from different sources supplying the flap. Our suggestion is to anastomose both the vessels to two recipient vessels to improve the flap circulation as clamping the vessels stopped the perfusion of corresponding regions of the flap.