A modification of technique to cover a large posterior thigh defect using an anterolateral thigh flap

Anterolateral thigh (ALT) flap is one of the popular flaps for soft-tissue reconstruction. It is a versatile flap which commonly used to resurface external skin defect and internal mucosal lining. In addition if raised as musculocutaneous flap, the muscle portion provides bulk to fill up any potential space. With increase knowledge on the vascular anatomy of this flap, it is possible to harvest 2 skin paddles base on more than one branches of the supplying vessel. This technique is commonly employed to provide coverage of more than one epithelial surfaces such as the complex facial defect after maxillectomy where both the cheek skin and oral mucosa reconstruction are required. Using similar concept, we report a case in which a large external skin defect was successfully covered with an ALT flap and the donor site could be closed primarily without skin grafting.