Related Experiment Video
Updated: Jul 3, 2026
07:57
An Experimental Human DIEP Flap Model to Investigate Preservation Strategies for Vascularized Composite Allografts and Free Flaps
Published on: December 5, 2025
Customized reconstruction with the free anterolateral thigh perforator flap
Holger Engel1, Emre Gazyakan, Ming-Huei Cheng
1Department of Plastic and Hand Surgery, Burn Center, Trauma Center Ludwigshafen, Plastic and Hand Surgery, The University of Heidelberg, Ludwigshafen, Germany. holgerengel@email.de
Microsurgery
|August 8, 2008
Summary
The free anterolateral thigh (ALT) flap is a reliable option for soft-tissue reconstruction, achieving a 96% success rate. Its versatility makes it ideal for various complex defects, especially in lower extremity reconstruction.
Area of Science:
- Plastic Surgery
- Reconstructive Surgery
Background:
- Soft-tissue defects pose significant reconstructive challenges.
- The anterolateral thigh (ALT) flap is a versatile option for reconstruction.
Observation:
- A retrospective review of 70 free ALT flaps transferred between April 2003 and September 2006 was conducted.
- Flaps were utilized for defects in the lower extremity (54), upper extremity (11), trunk (3), and head and neck (1).
- Different flap variations included cutaneous septocutaneous (11), myocutaneous "true" perforator (57), and fasciocutaneous perforator (2) types.
Findings:
- The overall success rate for free ALT flaps was 96%.
- Total flap failure occurred in 3 patients (4.28%), with successful reconstructions using alternative flaps or skin grafting.
- Partial flap failure occurred in 5 patients (7.14%), managed with skin grafting, a sural flap, or primary closure.
Implications:
- The free ALT flap is a reliable and consistent choice for soft-tissue reconstruction in diverse clinical scenarios.
- Its adjustable thickness and volume allow for customized reconstruction of complex defects.
- The flap's consistent anatomy and long pedicle facilitate its use as a workhorse flap.
