Free anterolateral thigh flaps for upper extremity soft tissue reconstruction.
BACKGROUND
Limb-threatening wounds of the upper extremity pose a challenge to the micro vascular surgeon. The aim of this study is to analyze the outcome of free anterolateral thigh flaps for upper extremity soft tissue reconstruction.


METHODS
A retrospective review of patients undergoing this procedure from 2005 to 2012 was performed. Case note analysis was performed to determine demographic and perioperative factors, and complications and outcomes.


RESULTS
Thirty-two patients with a mean age of 53 years (9-84 yrs) underwent upper extremity reconstruction with an anterolateral thigh (ALT) flap. There were 24 (75%) males and 8 (25%) females. The etiology of the soft tissue defects was: infection (44.6%); post-tumor ablation (40%); and trauma (15.6%). The defect site was most commonly in the forearm (53.1%), followed by the elbow (12.5 %), arm (12.5%) and hand (21.9%). The mean timing of free flap transfer was 6.8 days after admission to our institution (minimum 1 days, maximum 9 days). Mean operative time of surgery was 4 h 39 min (minimum 3 h 2 min, maximum 6 h 20 min). The mean hospitalization was 24.8 days (minimum 5, maximum 85). The ALT success rate was at 92.3%. Partial flap necrosis was documented in five cases (15.6%). Complete flap loss occurred in two post-traumatic cases who both lost their limbs.


CONCLUSIONS
This flap, in the hands of experienced surgeons, provides reliable coverage of upper extremity defects.
Abteilung für Plastische, Ästhetische und Spezielle Handchirurgie, Klinik für Orthopädie, Unfallchirurgie und Plastische Chirurgie, Universitätsklinik Leipzig, Deutschland.
Nick
N
Spindler
Department of Plastic, Reconstructive and Burns Surgery, Nottingham City Hospital, Nottingham, United Kingdom.
Sammy
S
Al-Benna
Klink für Plastische Chirurgie und Schwerbrandverletzte, Berufsgenossenschaftliches Klinikum Bergmannsheil Bochum, Deutschland.
Andrej
A
Ring
Klinik für Handchirurgie, Plastische Chirurgie und Brandverletzungen, Berufsgenossenschaftliche Unfallklinik Duisburg, Deutschland.
Heinz
H
Homann
Universitätsklinik für Plastische-, Rekonstruktive und Ästhetische Chirurgie, Handchirurgie, Evangelisches Krankenhaus Oldenburg, Deutschland.
Lars
L
Steinsträsser
Klinik für Unfallchirurgie/Plastische Chirurgie, Sarkomzentrum am Westdeutschen Tumorzentrum, Universitätsklinikum Essen, Deutschland.
Hans-Ulrich
HU
Steinau
Abteilung für Plastische, Ästhetische und Spezielle Handchirurgie, Klinik für Orthopädie, Unfallchirurgie und Plastische Chirurgie, Universitätsklinik Leipzig, Deutschland.
Stefan
S
Langer
free tissue flaps; reconstructive surgical procedures; upper extremity; wounds and injuries