Pedicled anterolateral thigh flap for contralateral groin composite defect

Area of Science:

• Reconstructive surgery
• Vascular surgery
• Surgical oncology

Background:

• Pedicled anterolateral thigh (ALT) flaps are standard for ipsilateral groin defects, relying on intact femoral vessels.
• Absence of external iliac and femoral vessels, often due to extensive tumor resections, precludes ipsilateral ALT flap use.
• Free flaps are also challenging due to the lack of suitable recipient vessels in such cases.

Observation:

• A case of a composite groin defect following wide resection of recurrent liposarcoma encasing major vessels was addressed.
• The defect was successfully reconstructed using a pedicled ALT flap harvested from the contralateral thigh.
• Key surgical techniques involved lengthening and medializing the vascular pedicle to reach the contralateral anterior superior iliac spine.

Findings:

• The contralateral pedicled ALT flap provided a viable and effective solution for a complex groin defect with absent ipsilateral vessels.
• The described modifications to the vascular pedicle ensured adequate blood supply without compromising the flap or recipient site.
• This approach demonstrates the adaptability of the ALT flap in challenging oncological reconstructions.

Implications:

• This technique expands reconstructive options for patients with extensive groin defects and compromised vasculature.
• It offers a potential alternative to free flaps when recipient vessels are unavailable.
• The study highlights the importance of innovative flap techniques in managing complex oncological resections.