Case Series of Anterolateral Thigh Free Flap Reconstruction in Rwanda

Area of Science:

• Microsurgery
• Plastic Surgery
• Reconstructive Surgery

Background:

• The anterolateral thigh free flap is a versatile reconstructive option for lower limb and head and neck defects.
• It offers a large skin paddle with a reliable vascular pedicle (descending branch of the lateral circumflex femoral artery).
• Ideal for complex soft tissue defects, it has minimal donor site morbidity and can include muscle or fascia.

Purpose of the Study:

• To present a case series illustrating the utility of the anterolateral thigh free flap.
• To demonstrate local microsurgical capacity through international collaboration.

Main Methods:

• Three patients with defects unsuitable for local flaps were selected.
• Preoperative assessment included detailed patient history (smoking, diabetes, vascular disease, radiotherapy) and computed tomography angiography.
• Standard preoperative workup was performed to confirm recipient vessel patency.

Main Results:

• Successful reconstruction was achieved in three patients with defects including scalp basal cell carcinoma and exposed tibia post-trauma.
• No cases of microvascular compromise, flap necrosis, or congestion occurred.
• All patients experienced postoperative flap fullness, potentially requiring future debulking.

Conclusions:

• This case series highlights the successful application of the anterolateral thigh free flap in complex reconstructive scenarios.
• The presented cases illustrate the potential of local microsurgical capacity facilitated by international collaboration.