title: [Clinical analysis of 35 flap crisis in anterolateral thigh free flaps].
abstract: PURPOSE：The aim of this study was to analyze the causes of anterolateral thigh (ALT) free flap compromise and improve the success rate of ALT.
  
  
  METHODS
  Patients were recruited from September 2005 to December 2012 in the Department of Oral and Maxillofacial Surgery of Central South University. All patients underwent reconstructive surgery using ALT free flaps. Outcome measures included ethnicity, defect type, incidence and timing of flap compromise, type of flap compromise (i.e. arterial or venous), causes of vascular occlusion and salvage rate. The data was analyzed using SPSS 16.0 software package.
  
  
  RESULTS
  There were a total of 812 ALT free flaps transplanted during 7 years. Among the 812 transferred flaps, 794 survived and 18 showed necrosis, the overall survival rate was 97.8%. 35 flap compromises due to vascular obstruction were identified and 18 flaps were salvaged completely after exploration. Venous occlusions occurred in 31 flaps (88.6%) and arterial occlusion in 4 flaps (11.4%). The successful salvage rate within 16 h was significantly higher than those over 16 h (70.6%: 27.8%, P=0.011). The successful salvage rate of venous occlusions was higher than that of arterial occlusion, but there was no significant difference.
  
  
  CONCLUSIONS
  Early detection, re-exploration, and effective handling of the flap crisis increase the rate of flap salvage tremendously. Prick test is the gold standard for early detection of flap compromise.
authors.affiliation: Department of Oromaxillofacial Head and Neck Oncology, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine. Shanghai 200011,China. E-mail:zhenhuren@126.com.
authors.forename: Zhen-hu
authors.initials: ZH
authors.lastname: Ren
authors.affiliation: Department of Oral and Maxillofacial Surgery, The Second Xiangya Hospital, Central South University. Changsha 410011, Hunan Province, China.
authors.forename: Han-jiang
authors.initials: HJ
authors.lastname: Wu
authors.affiliation: Department of Oral and Maxillofacial Surgery, The Second Xiangya Hospital, Central South University. Changsha 410011, Hunan Province, China.
authors.forename: Hong-yu
authors.initials: HY
authors.lastname: Tan
authors.affiliation: Department of Oral and Maxillofacial Surgery, The Second Xiangya Hospital, Central South University. Changsha 410011, Hunan Province, China.
authors.forename: Kai
authors.initials: K
authors.lastname: Wang
authors.affiliation: Department of Oral and Maxillofacial Surgery, The Second Xiangya Hospital, Central South University. Changsha 410011, Hunan Province, China.
authors.forename: Zhao-jian
authors.initials: ZJ
authors.lastname: Gong
authors.affiliation: Department of Oral and Maxillofacial Surgery, The Second Xiangya Hospital, Central South University. Changsha 410011, Hunan Province, China.
authors.forename: Sheng
authors.initials: S
authors.lastname: Zhang
mesh_terms: D058752:Free Tissue Flaps; D006801:Humans; D019651:Plastic Surgery Procedures / Q000706:statistics & numerical data*; D013515:Surgery, Oral / Q000706:statistics & numerical data*; D013848:Thigh