Thin anterolateral thigh perforator flap using a modified perforator microdissection technique and its clinical application for foot resurfacing.
BACKGROUND
A thin skin flap is often required for optimal resurfacing of particular areas of the body. An anterolateral thigh perforator flap can be thinned to an extent to which it is vascularized by the subdermal plexus only. This study presents a novel flap thinning technique and its application for resurfacing the dorsum of the foot.


METHODS
From July of 2002 to October of 2003, 18 patients underwent resurfacing of the dorsum of the foot with thin anterolateral thigh flaps. The main perforators were strategically located in the flap center to keep the peripheral area within the vascular territory. The flaps were larger than needed, initially elevated subfascially, and then thinned to the suitable thickness while the pedicle was still attached. The dissection of perforators in the adipose layer close to the dermis entry was carried out microscopically. Flap sizes ranged from 3 x 3 to 16 x 8 cm.


RESULTS
Seventeen flaps survived completely and one had distal superficial necrosis of 1 x 2 cm. No debulking procedures were necessary. Average follow-up was 12 months.


CONCLUSIONS
A thin flap vascularized through subdermal plexus is reliable. Microsurgical dissection of the perforator is a recommended technique. The thin anterolateral thigh perforator flap provides ideal reconstruction in resurfacing the dorsum of the foot.
Yang
Wen-Guei
WG
Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, ChiaYi, Taiwan. yang94@adm.cgmh.org
Chiang
Yuan-Cheng
YC
Wei
Fu-Chan
FC
Feng
Guan-Ming
GM
Chen
Kuang-Te
KT
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002908:Chronic Disease; D017719:Diabetic Foot / Q000601:surgery; D004210:Dissection / Q000379:methods*; D005260:Female; D018409:Foot Injuries / Q000601:surgery*; D016523:Foot Ulcer / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D013524:Surgical Flaps / Q000098:blood supply*; D013848:Thigh