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Anterolateral thigh free flap

J J Pribaz1, D P Orgill, M D Epstein

  • 1Division of Plastic Surgery, Brigham and Women's Hospital, Boston, MA 02115, USA.

Annals of Plastic Surgery
|June 1, 1995
PubMed
Summary
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The anterolateral thigh flap, utilizing the descending branch of the lateral femoral circumflex artery, offers a versatile solution for soft-tissue reconstruction with a 96% success rate. This flap is particularly effective for lower extremity reconstruction and can be performed with epidural anesthesia.

Area of Science:

  • Plastic Surgery
  • Reconstructive Surgery
  • Vascular Anatomy

Background:

  • The descending branch of the lateral femoral circumflex artery is a key vessel for anterolateral thigh flaps.
  • Understanding its anatomical course and perforator supply is crucial for reconstructive surgery.

Observation:

  • A series of 44 consecutive anterolateral thigh flaps were analyzed for soft-tissue reconstruction.
  • Flaps were utilized for defects in the lower extremity (25), upper extremity (10), and head and neck (9).

Findings:

  • The overall success rate for these anterolateral thigh flaps was 96%.
  • Two flap losses occurred due to thrombosis, both in lower extremity reconstructions.
  • The flap can be raised as a septofasciocutaneous flap or include a segment of vastus lateralis muscle.

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Implications:

  • The anterolateral thigh flap is a highly successful and versatile option for soft-tissue reconstruction, especially for lower extremities.
  • Its long, large-caliber vascular pedicle makes it suitable for flow-through procedures and allows for potential sensory restoration.
  • The procedure can be performed under epidural anesthesia, expanding its applicability to medically compromised patients.