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Related Experiment Video

Updated: Feb 23, 2026

An Experimental Human DIEP Flap Model to Investigate Preservation Strategies for Vascularized Composite Allografts and Free Flaps
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Differences between the Upper Extremity and the Lower Extremity in Reconstruction Using an Anterolateral Thigh

Sang Hyun Lee1, Jeung Tak Suh1, Tae Young Ahn1

  • 1Department of Orthopaedic Surgery, Medical Research Institute, Pusan National University Hospital, Busan, Korea.

Clinics in Orthopedic Surgery
|September 2, 2017
PubMed
Summary

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Clinical therapeutics·2026

This study compared anterolateral thigh (ALT) flap reconstructions for upper and lower extremities. Optimal flap elevation and debulking timing improved patient satisfaction and function in limb reconstructions.

Area of Science:

  • Plastic Surgery
  • Microsurgery
  • Reconstructive Surgery

Background:

  • Soft tissue defect reconstruction is a common surgical goal.
  • Upper and lower extremity reconstructions have distinct functional and aesthetic objectives.

Purpose of the Study:

  • To compare and analyze differences in upper and lower extremity reconstructions using anterolateral thigh (ALT) flaps.
  • To evaluate patient satisfaction based on ALT flap donor site and debulking procedure timing.

Main Methods:

  • Analysis of 74 patients undergoing ALT flap reconstruction (Oct 2006–Aug 2012).
  • Statistical analysis of patient satisfaction related to donor site and debulking timing.
  • Categorization of cases into upper extremity (45) and lower extremity (29) reconstructions.
Keywords:
Anterolateral thigh flapDebulkingUpper extremity and lower extremity

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Main Results:

  • Upper extremity reconstruction: Opposite-side flap elevation preferred (p=0.019) for reduced inconvenience.
  • Lower extremity reconstruction: Same-side flap elevation preferred (p=0.002).
  • Debulking at 4 weeks improved upper extremity outcomes (p=0.022); at 6 months improved lower extremity satisfaction (p<0.001).

Conclusions:

  • Optimized flap elevation (opposite for upper, same for lower extremities) reduces inconvenience.
  • Strategic debulking timing (4 weeks for upper, 6 months for lower extremities) enhances patient satisfaction and functional results.