Role of ALT Perforator Flaps in Head and Neck Reconstruction

The anterolateral thigh flap is a versatile flap that offers many advantages. These include a long and reliable pedicle that enables a wide arc of rotation, the possibility to harvest a large skin area, raising the flap with underlying fascia and minimal donor site morbidity. The purpose of this study is to show better esthetics and function with the use of ALT perforator flap in head and neck region. It is a large prospective case study done in our institute with regular follow-up which shows the outcomes of ALT flap.

From 2020 to 2022, hundred patients were reconstructed with anterolateral thigh flap. The flap was used for reconstruction in head and neck region. The patient group consisted of 53 males and 47 females. The age range was 30-90 years with a mean age of 61 years. Patients who had extensive soft tissue defect in the head and neck and had been reconstructed by free ALT flap have been reported. Flap data (type, length, and width), duration of flap elevation, donor-site morbidity, post-operative complications, and follow-up data including aesthetic and functional outcome were recorded.

We experienced no flap loss. The donor site was closed directly in twenty-eight out of eighty patients, and the remaining twenty patients were closed by split thickness skin grafting. Satisfactory aesthetic and functional outcome were achieved in all patients.

Our experience illustrates the versatility in the clinical application of the 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, highlight the diversity of defects that can be reconstructed using this flap.