Anterolateral thigh flap for axillary reconstruction after sarcoma resection

Area of Science:

• Microsurgery
• Surgical Oncology
• Reconstructive Surgery

Background:

• Reconstructing extensive axillary defects post-sarcoma resection is a significant challenge in reconstructive microsurgery.
• Previous ipsilateral latissimus dorsi flap use complicates reconstruction options for recurrent cases.

Purpose of the Study:

• To evaluate the feasibility and effectiveness of the free anterolateral thigh (ALT) flap for oncologic axillary reconstruction.

Main Methods:

• Free ALT flap reconstruction was performed on six patients with extensive axillary defects (15x11 to 28x25 cm²).
• Five patients had recurrent sarcomas, with three having prior latissimus dorsi flap use.
• Two patients required chest wall reconstruction using the iliotibial tract for full-thickness defects.

Main Results:

• All free ALT flaps demonstrated complete survival.
• Wound healing occurred without any complications in all treated patients.

Conclusions:

• The free ALT flap is an ideal choice for axillary reconstruction following extensive sarcoma resection.
• This flap allows customization to defect size and provides robust coverage for critical axillary structures.
• Harvesting in the lateral decubitus position facilitates a beneficial two-team surgical approach.