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Thin anterolateral thigh free flap
Nebojsa Rajacic1, Raj Kumar Gang, Jaya Krishnan
1Al-Babtain Centre for Burn & Plastic Surgery, Ibn Sina Hospital, Kuwait.
Annals of Plastic Surgery
|February 28, 2002
Summary
Extremely thin anterolateral thigh free flaps, thinned to 4-5 mm, can successfully cover shallow defects. This technique preserves venous drainage and demonstrates flap survival on a single perforator in 12 patients.
Area of Science:
- Plastic Surgery
- Reconstructive Surgery
- Microsurgery
Background:
- Increasing need for thin flaps in contouring or covering shallow defects from trauma, tumor ablation, or contracture release.
- Conventional flaps may be too bulky for these specific reconstructive challenges.
- The anterolateral thigh (ALT) flap is a versatile option, but extreme thinning is often required.
Observation:
- The authors utilized an extremely thin anterolateral thigh free flap (4-5 mm thickness) in 12 patients.
- Thinning involved removing deep fascia and subcutaneous fat, preserving a central 3-4 cm area around the perforator.
- Crucially, subdermal fat and superficial veins were maintained for venous outflow.
Findings:
- Successful coverage of shallow defects was achieved in all 12 patients using the extremely thin ALT flap.
- The thinned flaps demonstrated reliable survival, even when supplied by a single perforator.
- The technique allowed for precise contouring and coverage, addressing the limitations of bulkier flaps.
Implications:
- This method offers a viable solution for reconstructing shallow defects where thin tissue is paramount.
- The extreme thinning technique expands the reconstructive potential of the ALT flap.
- Further studies could explore long-term outcomes and applicability in diverse defect types.