Hand reconstruction with multi-pedicled anterolateral thigh flap

Area of Science:

• Microsurgery
• Plastic Surgery
• Hand Reconstruction

Background:

• Complex hand defects pose significant reconstructive challenges.
• The Anterolateral Thigh (ALT) flap is a versatile option in reconstructive microsurgery.
• Anatomical variations allow for multi-pedicle ALT flaps to address complex injuries.

Purpose of the Study:

• To evaluate the efficacy of multi-pedicle Anterolateral Thigh (ALT) flaps in complex hand reconstruction.
• To assess flap survival, functional, and aesthetic outcomes.
• To analyze factors influencing the success of this reconstructive technique.

Main Methods:

• Retrospective analysis of 116 patients treated with ALT flaps for hand lesions.
• Focus on 20 patients with complex defects treated with multi-pedicle flaps (adipocutaneous or combined adipocutaneous and fascial lata [FL] flaps).
• Flap thinning procedures and outcomes were documented.

Main Results:

• Overall flap survival rate was 97.5%.
• Multi-pedicle flaps, including those with two skin islands or combined skin and FL components, were effective for multi-unit hand reconstruction.
• High patient satisfaction reported for both functional and aesthetic results.

Conclusions:

• Multi-pedicle ALT flaps are a reliable and effective method for complex hand reconstruction.
• The technique offers excellent functional and aesthetic outcomes.
• Successful reconstruction depends on perforator selection, flap composition, thinning methods, and tailored flap design.