One plus one: Two free flaps from same donor thigh for simultaneous coverage of two different defects.

Area of Science:

• Microsurgery
• Reconstructive Surgery
• Orthopedic Surgery

Background:

• Simultaneous reconstruction of multiple defects using free flaps presents significant challenges, especially in trauma cases.
• Harvesting two independent free flaps from separate donor sites increases operative time and patient morbidity.
• A novel approach is needed to efficiently manage multiple defects with microvascular reconstruction.

Purpose of the Study:

• To evaluate the feasibility of simultaneously harvesting two independent free flaps—an anterolateral thigh (ALT) flap and a rectus femoris muscle flap—from the same thigh.
• To assess the efficacy of this dual-flap technique for covering distinct limb defects.

Main Methods:

• A retrospective study of five patients (2003-2012) with multiple limb defects requiring microvascular reconstruction.
• Ten free flaps were harvested from five donor sites, utilizing independent pedicles from the descending branch of the lateral circumflex femoral artery.
• Each patient received one ALT flap and one rectus femoris muscle flap for defect coverage.

Main Results:

• All ten reconstructive procedures were successfully completed without major complications.
• All harvested flaps demonstrated excellent survival rates.
• No re-explorations or donor site complications were reported.

Conclusions:

• Simultaneous harvesting of ALT and rectus femoris muscle flaps from the same thigh is a feasible and reliable method for reconstructing multiple limb defects.
• This technique offers significant advantages in terms of donor site economy and reduced operative time.
• It provides a valuable alternative for complex reconstructive challenges in microsurgery.