title: The anterolateral thigh flap is highly effective for reconstruction of complex lower extremity trauma.
abstract: BACKGROUND
  Trauma patients with high-energy injuries often present with severe tissue damage that extends beyond the immediate zone of injury and requires recruitment of vascularized tissues from distant sites. The objective of this study was to evaluate the utility of the anterolateral thigh (ALT) flap for reconstruction of the traumatically injured lower extremity.
  
  
  METHODS
  Prospective data were collected on all patients who underwent lower extremity reconstruction with an ALT flap during a 3.5-year period at a primary adult resource center (PARC). Demographics captured included age, gender, Injury Severity Score, mechanism of injury, and size of defect and complications.
  
  
  RESULTS
  Fifty-six patients underwent a total of 59 ALT flap harvests during the study period. The majority of patients were male (75%) and sustained blunt injury (95%). The mean age was 37 +/- 14 years with a mean Injury Severity Score of 17.9 +/- 8. The mean flap size was 20.7 x 8.4 cm, with 64% harvested from the injured limb. Total flap success rate was 91.5%, with four total (6.7%) and one partial flap failure (1.7%).
  
  
  CONCLUSIONS
  The ALT flap is a useful tool for trauma reconstruction in lower extremity salvage. We have shown that the ALT flap can be performed successfully in the traumatically injured patient even when harvested from the ipsilateral lower extremity.
authors.affiliation: Division of Plastic and Reconstructive Surgery, Johns Hopkins School of Medicine, Baltimore, Maryland, USA.
authors.forename: Julie E
authors.initials: JE
authors.lastname: Park
authors.forename: Eduardo D
authors.initials: ED
authors.lastname: Rodriguez
authors.forename: Rachel
authors.initials: R
authors.lastname: Bluebond-Langer
authors.forename: Grant
authors.initials: G
authors.lastname: Bochicchio
authors.forename: Michael R
authors.initials: MR
authors.lastname: Christy
authors.forename: Kelly
authors.initials: K
authors.lastname: Bochicchio
authors.forename: Thomas M
authors.initials: TM
authors.lastname: Scalea
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007869:Leg Injuries / Q000601:surgery*; D023821:Limb Salvage / Q000379:methods*; D008297:Male; D011446:Prospective Studies; D017695:Soft Tissue Injuries / Q000601:surgery*; D013524:Surgical Flaps; D016896:Treatment Outcome