Microdissected Thin Anterolateral Thigh Perforator Flaps with Multiple Perforators: A Series of Case Reports

Overview

Journal Medicine (Baltimore)

Specialty General Medicine

Date 2018 Jan 26

PMID 29369171

Authors

Jiu-Long Liang

Xiao-Yan Liu

Tao Qiu

Zhi-Qiang Fu

Hong-Yi Wang

Xu Kong

Kai Tao

Affiliations

Soon will be listed here.

Abstract

Introduction: The study aimed to explore the effect of microdissected thin anterolateral thigh (MTALT) perforator flap with multiple perforators on patients with complex defects on the hand, elbow, heel, or knee.

Methods: From March 2012 to February 2013, 5 patients with complex defects on the hand, elbow, heel, or knee were included. During the flap preparation, 2 to 3 perforators penetrating the fascia of the anterolateral femoral area were initially detected, and the deep fascia was incised. The superficial fascia layer of the flap and the deep adipose were then dissected, and removed after verifying the distribution of the blood vessels using an operating microscope. The whole flap was then elevated, and transposed to the recipient areas for microsurgical reparation.

Results: Two cases of post-burn scar contracture and 3 cases of traumatic tissue defects were successfully reconstructed with these multiple-perforator MTALT flaps. No complication was reported, and secondary operative procedure was not needed in any patient in the follow-up.

Conclusion: MTALT perforator flap with multiple perforators is safe and reliable for patients with complex defects on the hand, elbow, heel, or knee.

References

Kimura N, Satoh K . Consideration of a thin flap as an entity and clinical applications of the thin anterolateral thigh flap. Plast Reconstr Surg. 1996; 97(5):985-92. DOI: 10.1097/00006534-199604001-00016. View

Lin C, Chen L . Inclusion of extra perforators--a single and efficient measure to prevent vascular insufficiency in unreliable thoracodorsal artery perforator flaps. J Plast Reconstr Aesthet Surg. 2011; 65(3):342-50. DOI: 10.1016/j.bjps.2011.09.017. View

Hsieh C, Yang C, Kuo Y, Tsai H, Jeng S . Free anterolateral thigh adipofascial perforator flap. Plast Reconstr Surg. 2003; 112(4):976-82. DOI: 10.1097/01.PRS.0000076221.25738.66. View

Mosahebi A, Disa J, Pusic A, Cordeiro P, Mehrara B . The use of the extended anterolateral thigh flap for reconstruction of massive oncologic defects. Plast Reconstr Surg. 2008; 122(2):492-496. DOI: 10.1097/PRS.0b013e31817dc4c0. View

Kimura N . A microdissected thin tensor fasciae latae perforator flap. Plast Reconstr Surg. 2002; 109(1):69-77; discussion 78-80. DOI: 10.1097/00006534-200201000-00012. View

Adani R, Tarallo L, Marcoccio I, Cipriani R, Gelati C, Innocenti M . Hand reconstruction using the thin anterolateral thigh flap. Plast Reconstr Surg. 2005; 116(2):467-73. DOI: 10.1097/01.prs.0000173059.73982.50. View

Kimura N, Saito M, Sumiya Y, Itoh N . Reconstruction of hand skin defects by microdissected mini anterolataral thigh perforator flaps. J Plast Reconstr Aesthet Surg. 2008; 61(9):1073-7. DOI: 10.1016/j.bjps.2008.02.014. View

Sarkar A, Raghavendra S, Jeelani Naiyer M, Bhattacharya D, Dutta G, Bain J . Free thin anterolateral thigh flap for post-burn neck contractures - a functional and aesthetic solution. Ann Burns Fire Disasters. 2015; 27(4):209-14. PMC: 4544432. View

Kimura N, Satoh K, Hasumi T, Ostuka T . Clinical application of the free thin anterolateral thigh flap in 31 consecutive patients. Plast Reconstr Surg. 2001; 108(5):1197-208; discussion 1209-10. DOI: 10.1097/00006534-200110000-00015. View

10.

Liu W, Li H, Guo Z, Zhang Q, Yang A, Liu X . Reconstruction of soft-tissue defects of the head and neck: radial forearm flap or anterolateral thigh flap?. Eur Arch Otorhinolaryngol. 2011; 268(12):1809-12. DOI: 10.1007/s00405-011-1548-4. View

11.

Kimura N, Saitoh M, Hasumi T, Sumiya N, Itoh Y . Clinical application and refinement of the microdissected thin groin flap transfer operation. J Plast Reconstr Aesthet Surg. 2008; 62(11):1510-6. DOI: 10.1016/j.bjps.2008.06.039. View

12.

Keles M, Demir A, Kucuker I, Alici O . The effect of twisting on single and double based perforator flap viability: an experimental study in rats. Microsurgery. 2014; 34(6):464-9. DOI: 10.1002/micr.22247. View

13.

Wei F, Jain V, Celik N, Chen H, Chuang D, Lin C . Have we found an ideal soft-tissue flap? An experience with 672 anterolateral thigh flaps. Plast Reconstr Surg. 2002; 109(7):2219-26; discussion 2227-30. DOI: 10.1097/00006534-200206000-00007. View

14.

Wu J, Huang J, Tsao C, Abdelrahman M, Kolios G, Cheng M . Comparison of Posteromedial Thigh Profunda Artery Perforator Flap and Anterolateral Thigh Perforator Flap for Head and Neck Reconstruction. Plast Reconstr Surg. 2015; 137(1):257-266. DOI: 10.1097/PRS.0000000000001880. View

15.

Kimura N, Satoh K, Hosaka Y . Microdissected thin perforator flaps: 46 cases. Plast Reconstr Surg. 2003; 112(7):1875-85. DOI: 10.1097/01.PRS.0000091248.41007.2D. View

16.

Zhu Y, Wang Y, He X, Zhu M, Li F, Xu Y . Foot and ankle reconstruction: an experience on the use of 14 different flaps in 226 cases. Microsurgery. 2013; 33(8):600-4. DOI: 10.1002/micr.22177. View

17.

Kimura N, Saito M, Itoh Y, Sumiya N . Giant combined microdissected thin thigh perforator flap. J Plast Reconstr Aesthet Surg. 2006; 59(12):1325-9. DOI: 10.1016/j.bjps.2006.06.019. View

18.

Ali R, Bluebond-Langner R, Rodriguez E, Cheng M . The versatility of the anterolateral thigh flap. Plast Reconstr Surg. 2009; 124(6 Suppl):e395-e407. DOI: 10.1097/PRS.0b013e3181bcf05c. View

19.

Chang S, Zhang F, Yu G, Hou C, Gu Y . Modified distally based peroneal artery perforator flap for reconstruction of foot and ankle. Microsurgery. 2004; 24(6):430-6. DOI: 10.1002/micr.20069. View

20.

Leng J, LANG J, Guo L, Li H, Liu Z . Carcinosarcoma arising from atypical endometriosis in a cesarean section scar. Int J Gynecol Cancer. 2006; 16(1):432-5. DOI: 10.1111/j.1525-1438.2006.00199.x. View