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Updated: Mar 26, 2026
An Experimental Human DIEP Flap Model to Investigate Preservation Strategies for Vascularized Composite Allografts and Free Flaps
Published on: December 5, 2025
Salvage Free Anterolateral Thigh Composite Flap Transfer Based on the Musculocutaneous Perforator Retrograde Blood
Jingyi Zhao1, Fuan Chiang Chan, Xiaonan Yang
1*Department No. 16. of Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China †Department of Plastic and Reconstructive Surgery, St Vincent's University, Hospital ‡Suite 2, Blackrock Clinic Private Hospital, Dublin, Ireland.
Abstract:
An anterolateral thigh myo-adipofascial flap was used in the definitive management of a patient presented with chronic infective process associated with a large fronto-nasal defect. Unfortunately, the risk of free flap transfer failure emerged when intraoperative dissection showed absence of a reliable ipsilateral superficial temporal artery as the recipient artery. This rare incident happened at the stage whereby the anterolateral thigh flap was nearly completely raised with a distal perforator in situ. In this article, the authors presented an innovative strategy to salvage the flap by transforming the flap into a modified composite flap based on the retrograde blood flow principle. To the best of our knowledge, this is the first report of using such a technique in reconstructive microsurgery. This successful salvage strategy has clinical application and could potentially minimize free flap transfer failure.
