title: Clinical applications of the pedicled anterolateral thigh flap in reconstruction.
abstract: BACKGROUND
  Reconstruction of extensive defects of the lower abdomen, penoscrotum, trochanter, groin and knee without using complex microsurgery is a reconstructive challenge. Pedicled anterolateral thigh (ALT) flaps offer many advantages over other regional flaps for this purpose, such as the large skin area and soft-tissue availability, a remarkable pedicle length, and possessing multiple components and reliability. We present our experience of using pedicled ALT flaps for repairing various defects.
  
  
  METHODS
  From September 2006 to December 2013, 42 pedicled ALT flaps were used in 41 patients for defects of the lower abdomen (three patients), trochanter (26 patients), penoscrotum (10 patients), groin (one patient) and knee (one patient). Twenty-eight were men and 13 were women, and their mean age was 70.5 years (range, 22-103 years). The characteristics of the patients' age, sex, cause, flap size, flap component, follow-up and donor sites were recorded.
  
  
  RESULTS
  The flap size ranged from 8 × 5 cm (40 cm2) to 11 × 18 cm (198 cm2). The length of the pedicle ranged from 9 to 16 cm, which was enough to reach the defect without tension. No surgery-related mortality occurred. In 34 flaps, donor sites were closed primarily and eight underwent split-skin grafting. Satisfactory coverage was achieved in all patients.
  
  
  CONCLUSIONS
  Our experience has shown the wide arc of rotation, large skin replacement potential, multiple components and reliability of pedicled ALT flaps. They are technically simple to apply as myocutaneous/fasciocutaneous flaps with minimal donor site morbidity.
authors.affiliation: Division of Plastic and Reconstructive Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
authors.forename: Chin-Ta
authors.initials: CT
authors.lastname: Lin
authors.affiliation: Division of Plastic and Reconstructive Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
authors.forename: Chih-Hsing
authors.initials: CH
authors.lastname: Wang
authors.affiliation: Division of Plastic and Reconstructive Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
authors.forename: Kuang-Wen
authors.initials: KW
authors.lastname: Ou
authors.affiliation: Division of Plastic and Reconstructive Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
authors.forename: Shun-Cheng
authors.initials: SC
authors.lastname: Chang
authors.affiliation: Division of Plastic and Reconstructive Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
authors.forename: Niann-Tzyy
authors.initials: NT
authors.lastname: Dai
authors.affiliation: Division of Plastic and Reconstructive Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
authors.forename: Shyi-Gen
authors.initials: SG
authors.lastname: Chen
authors.affiliation: Division of Plastic and Reconstructive Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
authors.forename: Tim-Mo
authors.initials: TM
authors.lastname: Chen
authors.affiliation: Division of Plastic and Reconstructive Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
authors.forename: Yuan-Sheng
authors.initials: YS
authors.lastname: Tzeng
mesh_terms: D000005:Abdomen / Q000002:abnormalities / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005269:Femur / Q000002:abnormalities / Q000601:surgery; D006119:Groin / Q000601:surgery*; D006801:Humans; D007717:Knee / Q000002:abnormalities / Q000601:surgery; D008297:Male; D008875:Middle Aged; D064827:Myocutaneous Flap / Q000592:standards*; D019651:Plastic Surgery Procedures / Q000379:methods*; D015203:Reproducibility of Results; D016038:Skin Transplantation; D013524:Surgical Flaps / Q000706:statistics & numerical data*; D013848:Thigh / Q000601:surgery*
keywords: defect; pedicled anterolateral thigh flap; reconstruction