title: The usefulness of microsurgical pedicle lengthening in free anterolateral thigh flaps.
abstract: BACKGROUND
  A microsurgical pedicle-lengthening technique can be used when a pedicle length longer than that usually provided by an anterolateral thigh (ALT) flap is required. The purpose of this report is description of pedicle lengthening method from original pedicle length for free ALT flaps and presentation of the results of application of this technique in reconstruction from a series of cases.
  
  
  METHODS
  The microsurgical pedicle-lengthening procedure was used in 10 patients who received free ALT flaps from January 2012 to June 2015. The location of reconstruction was the heel in 3 patients, foot in 3 patients, flank in 2 patients, forehead in 1 patient, and lower leg in 1 patient. The technique was categorized as two distinct 2 types according to the branching pattern of the perforator. The transected segments of the extra vessel lengths were translocated anterogradely, and used to perform pedicle extensions.
  
  
  RESULTS
  The average length of the original pedicle was 13.1 cm (range 10.1-16.4 cm), and the average gain in length using the pedicle-lengthening method was 6.5 cm (range 5.0-8.1 cm). All the flaps survived well postoperatively. Of the 10 patients, three experienced complications that included partial flap necrosis in one patient, wound dehiscence in one patient, and seroma in the third patient. No major complications occurred.
  
  
  CONCLUSIONS
  The microsurgical pedicle-lengthening technique described here offers a solution for pedicles that are shorter than expected, with additional surgery required. This method may help overcome emergency situations that can arise during ALT flap surgery. © 2016 Wiley Periodicals, Inc. Microsurgery 36:559-566, 2016.
authors.affiliation: Department of Plastic and Reconstructive Surgery, The Catholic University of Korea, 222, Banpodaero, Seocho-gu, Seoul, 137-701, Republic of Korea.
authors.forename: Hyun Ho
authors.initials: HH
authors.lastname: Han
authors.affiliation: Department of Plastic and Reconstructive Surgery, The Catholic University of Korea, 222, Banpodaero, Seocho-gu, Seoul, 137-701, Republic of Korea.
authors.forename: Eun Jeong
authors.initials: EJ
authors.lastname: Choi
authors.affiliation: Department of Plastic and Reconstructive Surgery, The Catholic University of Korea, 222, Banpodaero, Seocho-gu, Seoul, 137-701, Republic of Korea.
authors.forename: Deuk Young
authors.initials: DY
authors.lastname: Oh
authors.affiliation: Department of Plastic and Reconstructive Surgery, The Catholic University of Korea, 222, Banpodaero, Seocho-gu, Seoul, 137-701, Republic of Korea. nasuko@catholic.ac.kr.
authors.forename: Suk Ho
authors.initials: SH
authors.lastname: Moon
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D058752:Free Tissue Flaps / Q000098:blood supply* / Q000637:transplantation*; D006801:Humans; D008297:Male; D008866:Microsurgery / Q000379:methods*; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011183:Postoperative Complications; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D013848:Thigh