The Anterolateral Thigh Perforator Flap is a Versatile Resource for Reconstructive Surgery

Abstract

The Aim of Work: The aim of this study was to increase the efficiency of reconstruction of extensive soft-tissue defects of various localizations by differentiated use of the anterolateral thigh (ALT) perforator flap. Methods: We have retrospectively reviewed 39 patients, who had undergone soft-tissue reconstruction using pedicled and free transposition of ALT flaps. Results: In this series, all cases ended with a complete recovery of patients with adequate restoration of integumentary tissues. In the postoperative course, we encountered complications during free flap transplantation in nine cases (23%), two of which were associated with arterial insufficiency (5.1%) and seven – with venous thrombosis (17.9%). Most of these complications were not critical, and the problem was resolved by conservative treatment; in two cases, partial tissue death required a secondary suture. In three cases (7.7%), the complications were critical and led to the loss of the flap. Conclusions: The unprecedented versatility and the minimal trauma of the donor area make the ALT perforator flap one of the most demanded skin flaps. Despite the variable vascular anatomy, the ALT flap is the most adaptable plastic resource for extensive soft-tissue coverage of abdominal, perineal, and hip joints as a transposition flap on the vascular leg and for closing distant defects in any area of the body using it as a free microsurgical transplant. Other advantages include its variability in size and the ability to harvest multiple tissue components in different combinations depending on the desired outcome.