The Pedicled Anterolateral Thigh Flap as a Versatile Option for Resurfacing Extensive Lower Trunk Defects.

Area of Science:

• Plastic Surgery
• Reconstructive Surgery
• Surgical Oncology

Background:

• Reconstructing large abdominal and perineal defects presents significant challenges for surgeons.
• Achieving stable soft-tissue coverage and strong fascial closure is crucial to prevent hernia recurrence and contamination.
• The pedicled anterolateral thigh flap (ALT) is a versatile option for these complex reconstructions.

Purpose of the Study:

• To evaluate the efficacy of the pedicled anterolateral thigh flap (ALT) in reconstructing extensive abdominal and perineal defects.
• To address the limited research on ALT flap utilization among Black Africans, particularly in Nigeria.
• To present institutional experience with ALT flaps for challenging defect closures.

Main Methods:

• A retrospective review of patient records who underwent pedicled anterolateral thigh flap (ALT) reconstruction between January 2019 and July 2022.
• Extraction of demographic data and flap reconstruction details from patient folders.
• Analysis of flap outcomes in patients with extensive abdominal and perineal defects.

Main Results:

• The study included five patients (3 males, 2 females) aged 22-48 years.
• Indications for reconstruction included tumor extirpation (4 cases) and necrotizing fasciitis (1 case).
• Four flaps achieved full survival, with one experiencing marginal flap tip loss; no intraoperative anatomical variations were noted.

Conclusions:

• The pedicled anterolateral thigh flap (ALT) is a highly effective reconstructive option for extensive abdominal and perineal defects.
• The flap demonstrates reliability and good outcomes in the Nigerian population for complex reconstructions.
• ALT flap offers a valuable solution for surgeons managing challenging soft-tissue defects.