title: Supercharging and augmenting venous drainage of an anterolateral thigh free flap: options and indications.
abstract: This study introduces the options for supercharging and augmenting venous drainage of an anterolateral thigh free flap. Clinical indications and options for additional microvascular anastomoses are reviewed in 5 consecutive patients. The indications were simultaneous mucosal and cutaneous defects, divergent mucosal defects, and extensively wide and long cutaneous defects. Three additional vascular pedicles were anastomosed: the transverse branch of the lateral circumflex (n = 3), a perforator coming directly off the superficial femoral artery (n = 1), and a posterior perforator from the profundus femoral artery (n = 1). The anastomosis of a separate pedicle from the superior, medial, and/or posterior-lateral thigh may be a useful technique when confronted with an extensive defect that may not reliably be reconstructed with a routine anterolateral thigh flap based on a single perforator.
authors.affiliation: Division of Plastic Surgery, Department of Surgery, University of Colorado School of Medicine, Aurora, Colo.; Department of Otolaryngology, University of Colorado School of Medicine, Aurora, Colo.; and University of Colorado School of Medicine, Aurora, Colo.
authors.forename: Frederic W-B
authors.initials: FW
authors.lastname: Deleyiannis
authors.affiliation: Division of Plastic Surgery, Department of Surgery, University of Colorado School of Medicine, Aurora, Colo.; Department of Otolaryngology, University of Colorado School of Medicine, Aurora, Colo.; and University of Colorado School of Medicine, Aurora, Colo.
authors.forename: Austin M
authors.initials: AM
authors.lastname: Badeau
authors.affiliation: Division of Plastic Surgery, Department of Surgery, University of Colorado School of Medicine, Aurora, Colo.; Department of Otolaryngology, University of Colorado School of Medicine, Aurora, Colo.; and University of Colorado School of Medicine, Aurora, Colo.
authors.forename: Ted H
authors.initials: TH
authors.lastname: Leem
authors.affiliation: Division of Plastic Surgery, Department of Surgery, University of Colorado School of Medicine, Aurora, Colo.; Department of Otolaryngology, University of Colorado School of Medicine, Aurora, Colo.; and University of Colorado School of Medicine, Aurora, Colo.
authors.forename: John I
authors.initials: JI
authors.lastname: Song