[Vascular pedicle elongation technique in anterolateral thigh island flap transplantation]

To introduce a new technique for vascular pedicle elongation in the anterolateral thigh island flap transplantation and evaluate the outcome of this technique in the clinical application.

From January 2003 to January 2006, 6 patients (5 males, 1 female; age, 18-49 years) were admitted for surgical operation because of the soft tissue defect around the knee joint. The soft tissue defect after the injury was found in 3 patients, the defect after the removal of the soft-tissue tumor in 1, and the defect after the prosthetic replacement in the knee joint in 2. The soft tissue defects ranged in size of 8 cm x 4 cm to 15 cm x 6 cm. When the anterolateral island flap of the thigh underwent the reverse transplantation, the ascending branch of the lateral circumflex femoral artery was used as a nutrient vessel for the flap, and the descending branch of the lateral circumflex femoral artery was separated to the distal part. The main trunk of the lateral circumflex femoral artery was ligated at the point that was proximal to the furcation of the ascending and decending branches so that the vessel pedicle of the flap could be lengthened and then the defect was repaired. The flaps ranged in size of 10 cm x 6 cm to 18 cm x 8 cm.

All the flaps were successfully transferred in the 6 patients. The lengthened pedicle ranged in length from 8 to 12 cm, with an average of 10 cm. There was no vascular crisis after operation. All the transferred flaps survived, with a color and texture similar to those in the recipient site. The postoperative follow-up for 6-18 months revealed that the motion range of the knees was satisfactory.

The vascular pedicle elongation technique can enlarge the application scope of the anterolateral thigh island flap and the survival rate of the flap is not influenced by any factor.