Application of Huge Bipedicle Anterolateral Thigh Free Flaps for Reconstructing Extensive Soft-Tissue Defects

Area of Science:

• Plastic Surgery
• Reconstructive Surgery
• Microsurgery

Background:

• Anterolateral thigh free flaps are crucial for complex wound reconstruction.
• Partial flap loss is a persistent challenge, especially with large perforator flaps.
• This study investigates bipedicle versus single-pedicle anterolateral thigh free flaps for large reconstructions.

Purpose of the Study:

• To compare the outcomes of bipedicle anterolateral thigh free flap procedures with single-pedicle free flaps.
• To evaluate the efficacy of bipedicle flaps in reconstructing extensive soft tissue defects using large flaps.

Main Methods:

• Retrospective study of 70 patients (72 procedures) with large anterolateral thigh free flaps (≥240 cm², >30 cm).
• Review of patient demographics, flap size, surgical technique, and perioperative/postoperative outcomes.
• Comparison between bipedicle and single-pedicle flap reconstruction groups.

Main Results:

• No significant demographic differences between groups.
• Eight bipedicle anterolateral thigh free flap procedures were performed.
• Bipedicle flaps showed significantly lower complication rates compared to single-pedicle flaps (P = 0.0215), with no difference in ischemic time, operative time, or donor site complications.

Conclusions:

• Bipedicle anterolateral thigh free flap is a reliable method for extensive soft tissue defect reconstruction.
• This technique offers a viable alternative for managing large flaps and reducing complications.
• The study supports the use of bipedicle flaps for complex reconstructive needs.