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Free Skin Anterolateral Thigh Flap and Vacuum-Assisted Closure Therapy for Reconstruction of Snakebite-Induced
Phan Tuấn Nghĩa1,2,3, Trần Thiết Sơn1,2,3, Tạ Thị Hồng Thúy1,2
1Department of Plastic and Reconstructive Surgery, Hanoi Medical University, Hanoi, Vietnam.
Therapeutics and Clinical Risk Management
|January 1, 2026
Summary
A staged approach using vacuum-assisted closure (VAC) therapy and anterolateral thigh (ALT) flaps effectively reconstructs severe hand defects from cobra bites. This method promotes wound healing and functional recovery in snakebite victims.
Area of Science:
- Plastic Surgery
- Reconstructive Surgery
- Toxicology
Background:
- Cobra envenomation in tropical regions often causes severe hand tissue necrosis.
- Complex hand defects from snakebites pose significant reconstructive challenges.
Purpose of the Study:
- To evaluate a staged reconstructive approach for hand defects caused by cobra envenomation.
- To assess the efficacy of vacuum-assisted closure (VAC) therapy combined with free anterolateral thigh (ALT) flaps.
Main Methods:
- Eleven patients with hand defects from cobra bites underwent debridement and VAC therapy.
- Definitive reconstruction was performed using tailored free ALT flaps (fasciocutaneous or thinned).
- Outcomes assessed included flap viability, range of motion, and complications.
Main Results:
- Mean VAC therapy duration was 11.5 days; 11 ALT flaps were used.
- Flap thinning was performed in 72.7% of cases.
- Functional range of motion was achieved postoperatively; flap bulkiness was the main issue.
Conclusions:
- A staged VAC therapy and free ALT flap approach is safe and effective for complex hand defects from cobra bites.
- This strategy optimizes wound conditions and provides versatile tissue coverage for functional recovery.
