title: Customized reconstruction with the free anterolateral thigh perforator flap.
abstract: From April of 2003 through September of 2006, 70 free anterolateral thigh (ALT) flaps were transferred for reconstructing soft-tissue defects. The overall success rate was 96%. Among 70 free ALT flaps, 11 were elevated as cutaneous ALT septocutaneous vessel flaps. Fifty-seven were harvested as cutaneous ALT myocutaneous "true" perforator flaps. Two flaps were used as fasciocutaneous perforator flaps based on independent skin vessels. Fifty-four ALT flaps were used for lower extremity reconstruction, 11 flaps were used for upper extremity reconstruction, 3 flaps were used for trunk reconstruction, and 1 flap was used for head and neck reconstruction. Total flap failure occurred in 3 patients (4.28% of the flaps), and partial failure occurred in 5 patients (7.14% of the flaps). The three flaps that failed completely were reconstructed with a free radial forearm flap, a latissimus dorsi flap and skin grafting, respectively. Among the five flaps that failed partially, three were reconstructed with skin grafting, one with a sural flap, and one with primary closure. The free ALT flap has become the workhorse for covering defects in most clinical situations in our center. It is a reliable flap with consistent anatomy and a long, constant pedicle diameter. Its versatility, in which thickness and volume can be adjusted, leads to a perfect match for customized reconstruction of complex defects.
authors.affiliation: Department of Plastic and Hand Surgery, Burn Center, Trauma Center Ludwigshafen, Plastic and Hand Surgery, The University of Heidelberg, Ludwigshafen, Germany. holgerengel@email.de
authors.forename: Holger
authors.initials: H
authors.lastname: Engel
authors.forename: Emre
authors.initials: E
authors.lastname: Gazyakan
authors.forename: Ming-Huei
authors.initials: MH
authors.lastname: Cheng
authors.forename: David
authors.initials: D
authors.lastname: Piel
authors.forename: Guenter
authors.initials: G
authors.lastname: Germann
authors.forename: Goetz
authors.initials: G
authors.lastname: Giessler
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016512:Ankle Injuries / Q000601:surgery; D005260:Female; D018409:Foot Injuries / Q000601:surgery; D050723:Fractures, Bone / Q000601:surgery*; D006801:Humans; D006810:Humeral Fractures / Q000601:surgery; D008297:Male; D008875:Middle Aged; D019651:Plastic Surgery Procedures; D012887:Skull Fractures / Q000601:surgery; D017695:Soft Tissue Injuries / Q000601:surgery; D013524:Surgical Flaps; D013978:Tibial Fractures / Q000601:surgery; D055815:Young Adult