Versatility of the pedicled anterolateral thigh flap for surgical reconstruction, a case series

The pedicled anterolateral thigh flap is a versatile flap that offers many advantages. These include a long and reliable pedicle that enables a wide arch of rotation, the possibility to harvest a large skin area, raising the flap with underlying fascia and muscle and minimal donor site morbidity.

From 2009 to 2018 nine patients were reconstructed with a pedicled anterolateral thigh flap. The flap was applied for coverage of knee infections, trochanteric defects, an abdominal defect, a gluteal defect, and a defect of the inguinal region. The patient group consisted of five males and four females. The age range was 30-90 years with a mean age of 61 years.

Flap size ranged from 10 x 5 cm (50 cm²) to 15 x 30 cm (450 cm²) with a mean size of 222 cm². We experienced no flap loss. The donor site was closed directly in seven out of nine patients, and the remaining two patients were closed by split-thickness skin grafting. Satisfactory aesthetic and functional outcome was achieved in all patients.

Our experience illustrates the versatility in the clinical application of the pedicled anterolateral thigh flap. The many advantages of the flap, such as the long and reliable pedicle, a large area of skin that can be harvested, the potential to supercharge the flap and the minimal donor site morbidity highlights the diversity of defects that can be reconstructed using this flap.