title: Clinical anatomical study and evaluation of the use of the free anteromedial thigh perforator flaps in reconstructions of the head and neck.
abstract: The anteromedial thigh (AMT) perforator flap is usually thin, pliable, and nearly hairless, making it particularly suitable to repair defects of the head and neck. We studied the topography and outcomes of AMT perforator flaps in such defects after excision of tumours. We retrospectively reviewed the casenotes of 11 consecutive patients who had had reconstructions of the head and neck with the initial intent of using an AMT perforator flap from January 2010 to July 2011. For each patient we recorded the size and thickness of the flap; the length of the pedicle; and the number, external diameters, anatomical types, source vessels, and sites of the sizeable perforators. Of the 11 patients, 10 had successful reconstruction using AMT perforator flaps, but one had no AMT perforator big enough. The mean (range) number of sizeable perforators/flap was 1.3 (1-2), length of pedicle 10.6 (7-13) cm, and diameter of the artery 1.1(1.0-1.5) mm. Of the 13 sizeable perforators, 3 were direct and septocutaneous. The remaining ones were all musculocutaneous. Most of them were located in the middle third of the thigh. Primary closure of the donor site was achieved in all patients. One flap was successfully revised after compression of the perforator. All flaps survived with good functional and aesthetic outcomes. The free AMT perforator flap is suitable for reconstructions of the head and neck if a sizeable perforator can be found. The AMT flap may be used as a primary flap rather than as an alternative to the anterolateral thigh flap or a component of a chimeric flap.
authors.affiliation: Department of Oromaxillofacial-Head and Neck Surgery, School of Stomatology, China Medical University, No. 117, Nanjing North Street, Heping District, Shenyang, Liaoning 110002, PR China; Department of Oral and Maxillofacial Surgery, School of Stomatology, China Medical University, No. 117, Nanjing North Street, Heping District, Shenyang, Liaoning 110002, PR China. Electronic address: xzf7090@hotmail.com.
authors.forename: Zhong-Fei
authors.initials: ZF
authors.lastname: Xu
authors.forename: Chang-Fu
authors.initials: CF
authors.lastname: Sun
authors.forename: Wei-Yi
authors.initials: WY
authors.lastname: Duan
authors.forename: En-Jiao
authors.initials: EJ
authors.lastname: Zhang
authors.forename: Wei
authors.initials: W
authors.lastname: Dai
authors.forename: Xiao-Jiao
authors.initials: XJ
authors.lastname: Zheng
authors.forename: Fa-Yu
authors.initials: FY
authors.lastname: Liu
authors.forename: Xue-Xin
authors.initials: XX
authors.lastname: Tan
mesh_terms: D000328:Adult; D000368:Aged; D001158:Arteries / Q000033:anatomy & histology; D002294:Carcinoma, Squamous Cell / Q000601:surgery; D004954:Esthetics; D005205:Fascia / Q000637:transplantation; D005260:Female; D005263:Femoral Artery / Q000601:surgery; D005500:Follow-Up Studies; D005927:Glossectomy / Q000379:methods; D006085:Graft Survival; D006801:Humans; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000601:surgery*; D064827:Myocutaneous Flap / Q000098:blood supply / Q000637:transplantation; D061525:Perforator Flap / Q000098:blood supply / Q000637:transplantation*; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D016038:Skin Transplantation / Q000379:methods; D013848:Thigh / Q000033:anatomy & histology* / Q000601:surgery; D014062:Tongue Neoplasms / Q000601:surgery; D060053:Transplant Donor Site / Q000033:anatomy & histology / Q000601:surgery; D016896:Treatment Outcome