Anterolateral thigh free flap for "head-to-toe" reconstruction

Area of Science:

• Plastic Surgery
• Reconstructive Surgery
• Microsurgery

Background:

• The anterolateral thigh (ALT) free flap is a widely adopted technique in reconstructive surgery.
• Its versatility stems from its size variability, malleability, and a low-morbidity donor site.
• The ALT flap is suitable for complex reconstructions across various anatomical regions.

Purpose of the Study:

• To review the institutional case series of ALT free flap harvests at the University of Florida.
• To elucidate the widespread adaptability and applications of the ALT flap.
• To share institutional experience regarding indications, outcomes, and complications.

Main Methods:

• Retrospective review of 20 patients undergoing ALT free flap harvest.
• Analysis of flap characteristics, including area, venous anastomoses, and vein diameter.
• Review of indications, recipient sites, donor site management, complications, and outcomes.

Main Results:

• ALT flaps were used for scalp, trunk, head and neck, and lower extremity defects.
• The majority of defects were oncologic (16 patients), followed by traumatic (2) and burn (2) injuries.
• Average flap area was 157 cm², with an average of 1.47 venous anastomoses and 2.65 mm vein diameter.

Conclusions:

• The anterolateral thigh (ALT) free flap demonstrates significant adaptability for diverse reconstructive needs.
• It is a reliable option for complex defects, particularly in oncologic cases.
• Further review of the literature supports the broad utility of the ALT flap in reconstructive surgery.