The anterolateral thigh flap is highly effective for reconstruction of complex lower extremity trauma.
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.
Park
Julie E
JE
Division of Plastic and Reconstructive Surgery, Johns Hopkins School of Medicine, Baltimore, Maryland, USA.
Rodriguez
Eduardo D
ED
Bluebond-Langer
Rachel
R
Bochicchio
Grant
G
Christy
Michael R
MR
Bochicchio
Kelly
K
Scalea
Thomas M
TM
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