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Journal of the Korean Society for Surgery of the Hand 2005;14(2):117-124.
Published online October 31, 2005.
The Usefulness of the Anterolateral Thigh flap for Reconstructing Soft Tissue Defects
Chung-Hoon Lee, M.D., Jae-Hoon Lee, M.D., Jae-Yun Jo, M.D., Duke-Whan Chung, M.D.*
연부조직결손의 재건을 위한 전외측 대퇴부 피판술의 유용성
Purpose: To present our experience and design modification of an anterolateral thigh flap in soft tissue reconstruction.
Materials and Methods : Between April of 2004 and May of 2005, 26 anterolateral thigh flaps were used in 26 patients. There were 22 males and 4 females between 23 and 60 years (mean, 40years). The mean follow-up period was 11(4~18) months. All cases were a cutaneous flap. Twenty-two were musculocutaneous perforator flaps(85%) and 4 were septocutaneous perforator flaps(15%). Four flaps were used as a sensate flap. While the donor sites were closed directly in 14 cases(54%), 12 cases(46%) underwent skin grafting of the donor site. During the flap design, a triangular skin design was added to a vascular anastomosis site in 14(54%) patients and used as a roof of the tunnel. The healing period of the skin graft between those performed above the fascia and above the muscle were compared.
Results: The average size of the flaps was 16×9(11-20×7-12) cm. The overall flap success rate was 96%. Complications encountered were infection in 4 cases, and marginal skin necrosis in 1 case. The healing period was delayed with the infection in 3 of the 6 cases involving a skin graft over the fascia. All 14 cases with the triangular skin design survived, but there was 1 flap failure and 1 marginal necrosis in 12 cases without a triangular skin design.
Conclusions: It may be better to undergo a skin graft above the muscle than above the fascia in covering a donor site defect, and to use a triangular skin design in order to prevent vascular insufficiency. An anterolateral thigh flap is a versatile flap for a soft tissue reconstruction because its thickness and volume can be adjusted to the extent of the defect with minimal donor site morbidity.
Key Words: Soft tissue defect, Reconstruction, Free flap, Anterolateral thigh flap.

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