title: Use of Flow-Through Anterolateral Thigh Perforator Flaps in Reconstruction of Complex Extremity Defects.
abstract: BACKGROUND
  The flow-through flap has been widely utilized for reconstruction of complex defects of the extremities as it can be used for arterial reconstruction and soft-tissue coverage simultaneously. This study describes our clinical experience with the application of the flow-through anterolateral thigh perforator (ALTP) flap for reconstruction of complex defects of the extremities.
  
  
  METHODS
  From January 2008 to June 2011, we retrospectively analyzed 16 patients with complex defects in the limbs. In two patients the defects occurred after undergoing wide excision of chronic ulcer, while 14 defects were due to trauma. All patients in this series underwent reconstruction with the flow-through ALTP flap. Applications of flow-through performed include preserving the recipient artery flow, rebuilding the major artery gap, bridging the artery and concomitant vein simultaneously, and combining the ALTP with another free flap.
  
  
  RESULTS
  Flow-through ALTP flaps were used to preserve recipient flow (n = 5), rebuild the vessel gap (n = 2), bridge the artery and concomitant vein simultaneously (n = 2), and in combination with another free flap (n = 7). Follow-up ranged from 3 to 36 months (mean, 12 months). All flaps were successful; only two combination flaps required reexploration because of vessel crisis, and two patients suffered minor degrees of wound-edge necrosis. The donor sites healed well in all cases, without any complications.
  
  
  CONCLUSIONS
  Our experience showed that the flow-through ALTP flap is reliable and suitable for reconstruction of complex defects of the extremities, as well as for various other clinical purposes.
authors.affiliation: Department of Hand and Microsurgery, Xiangya Hospital of Central South University, Changsha, People's Republic of China.
authors.forename: Liming
authors.initials: L
authors.lastname: Qing
authors.affiliation: Department of Hand and Microsurgery, Xiangya Hospital of Central South University, Changsha, People's Republic of China.
authors.forename: Pangfeng
authors.initials: P
authors.lastname: Wu
authors.affiliation: Department of Hand and Microsurgery, Xiangya Hospital of Central South University, Changsha, People's Republic of China.
authors.forename: Jieyu
authors.initials: J
authors.lastname: Liang
authors.affiliation: Department of Hand and Microsurgery, Xiangya Hospital of Central South University, Changsha, People's Republic of China.
authors.forename: Fang
authors.initials: F
authors.lastname: Yu
authors.affiliation: Department of Hand and Microsurgery, Xiangya Hospital of Central South University, Changsha, People's Republic of China.
authors.forename: Congyang
authors.initials: C
authors.lastname: Wang
authors.affiliation: Department of Hand and Microsurgery, Xiangya Hospital of Central South University, Changsha, People's Republic of China.
authors.forename: Juyu
authors.initials: J
authors.lastname: Tang
mesh_terms: D000293:Adolescent; D000328:Adult; D001134:Arm Injuries / Q000503:physiopathology / Q000601:surgery; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection; D006085:Graft Survival; D006801:Humans; D015601:Injury Severity Score; D007869:Leg Injuries / Q000503:physiopathology / Q000601:surgery; D008297:Male; D008866:Microsurgery / Q000379:methods; D008875:Middle Aged; D061525:Perforator Flap / Q000098:blood supply / Q000637:transplantation*; D019651:Plastic Surgery Procedures / Q000009:adverse effects / Q000379:methods*; D012189:Retrospective Studies; D018570:Risk Assessment; D017695:Soft Tissue Injuries / Q000175:diagnosis / Q000601:surgery*; D013848:Thigh / Q000601:surgery*; D016896:Treatment Outcome; D014945:Wound Healing / Q000502:physiology*; D055815:Young Adult