title: The ultra-thin, fascia-only anterolateral thigh flap.
abstract: BACKGROUND
  While many potential donor sites have been described for fascial (fascia-only) flaps, a fascial flap harvested from the anterolateral thigh (ALT) donor site has not gained popularity, likely because of concerns regarding inadequate perfusion of the deep fascia. However, recent clinical experience demonstrates that the ALT fascia-only flap is a suitable option for reconstructions necessitating thin and pliable coverage.
  
  
  METHODS
  In this study a retrospective chart review was performed examining the clinical experience of two plastic surgeons with the fascia-only ALT perforator flap from 2008 to 2012. Each flap was initially raised as a standard ALT flap, but all the overlying skin and adipose tissue was excised off the deep fascia before the inset, resulting in the creation of a fascia-only ALT flap. Immediate split- or full-thickness skin grafts were used to cover the flap. The results are reported in this article.
  
  
  RESULTS
  Overall seven patients underwent reconstruction of wounds using either free (six) or pedicled (one) fascia-only ALT flaps (length, 10-20 cm, width, 5-10 cm). The following regions were successfully reconstructed using a fascia-only ALT flap: occipital scalp, lower extremity, upper extremity, and groin. All patients were followed for at least 6 months postoperatively.
  
  
  CONCLUSIONS
  The fascia-only ALT flap was successfully used to reconstruct a variety of defects in seven patients. The authors experience demonstrates the viability of the fascia-only version of the ALT flap for reconstructions requiring thin coverage with good contour, and further adds to the versatility of the ALT as a donor site for flaps.
authors.affiliation: Division of Plastic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas.
authors.forename: Mohin A
authors.initials: MA
authors.lastname: Bhadkamkar
authors.affiliation: Division of Plastic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas.
authors.forename: Erik M
authors.initials: EM
authors.lastname: Wolfswinkel
authors.affiliation: Division of Plastic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas.
authors.forename: Daniel A
authors.initials: DA
authors.lastname: Hatef
authors.affiliation: Division of Plastic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas.
authors.forename: Steven B
authors.initials: SB
authors.lastname: Albright
authors.affiliation: Division of Plastic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas.
authors.forename: Anthony
authors.initials: A
authors.lastname: Echo
authors.affiliation: Division of Plastic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas.
authors.forename: Patrick W
authors.initials: PW
authors.lastname: Hsu
authors.affiliation: Division of Plastic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas.
authors.forename: Shayan A
authors.initials: SA
authors.lastname: Izaddoost
mesh_terms: D000328:Adult; D006230:Hand Injuries / Q000601:surgery; D006801:Humans; D007869:Leg Injuries / Q000601:surgery; D008297:Male; D008875:Middle Aged; D061525:Perforator Flap; D019651:Plastic Surgery Procedures / Q000379:methods*; D012535:Scalp / Q000293:injuries; D016038:Skin Transplantation; D055815:Young Adult