DESIGN AND APPLICATION OF ANTEROLATERAL THIGH FREE FLAP WITH OBLIQUE BRANCH_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

 LIMeng , LANXu , ZHENPing , GAOQiuming , LIZhilin , GAOJie , YANGQiaoqiao , GAIYanlin

Department of Orthopaedics, Research Institute of Chinese PLA, Lanzhou General Hospital, Lanzhou Gansu, 730050, P. R. China;

Corresponding author：

LIMeng, Email: lilionli@126.com

Keywords：

Anterolateral thigh flap; Oblique branch; Soft tissue defect of lower extremity; Wound repair

DOI：

10.7507/1002-1892.20140191

Video：

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Objective To investigate the feasibility of the anterolateral thigh free flap with the oblique branch in reconstructing the soft tissue defects of lower extremity. Methods Between June 2009 and February 2013,12 patients (including 7 males and 5 females) with soft tissue defects of lower extremity were treated with the anterolateral thigh free flap with the oblique branch,aged from 8 to 42 years (median,32 years).The locations of soft tissue defect were the dorsum of the foot in 5 cases,the ankle and foot in 4 cases,the lower leg in 2 cases,and the distal foot in 1 case.All defects were associated with exposure of tendon and bone.The size of the wound was from 15 cm×7 cm to 27 cm×12 cm.The interval of injury and operation was 1 to 7 days (mean,3.7 days).The anterolateral thigh flap was pedicled with only the oblique branch in 7 patients,and with the both descending branch and oblique branch in 5 patients,and the size of flap was from 17 cm×9 cm to 30 cm×15 cm.The donor sites were repaired by suture in 3 patients,and by skin graft in 9 patients. Results Distal skin flap necrosis occurred in 1 case,and was cured after dressing change and skin graft.The other flaps survived,and the donor site healed primarily.The follow-up time was from 10 months to 2 years (mean,18 months).Thinning operation was performed in 3 cases,and the other flaps recovered pain and warm sensation with good appearance. Conclusion It is a safe and effective method to reconstruct soft tissue defects of the lower extremity with the anterolateral thigh flap pedicled with the oblique branch.

Citation： LIMeng, LANXu, ZHENPing, GAOQiuming, LIZhilin, GAOJie, YANGQiaoqiao, GAIYanlin. DESIGN AND APPLICATION OF ANTEROLATERAL THIGH FREE FLAP WITH OBLIQUE BRANCH. Chinese Journal of Reparative and Reconstructive Surgery, 2014, 28(7): 865-868. doi: 10.7507/1002-1892.20140191 Copy

1.	冯亚高,陶忠生,吕振木,等.游离股前外侧皮瓣坏死原因分析及血管变异的处理.解放军医药杂志,2013,25(7):111-112.
2.	Wong CH,Wei FC,Fu B,et al.Alternative vascular pedicle of the anterolateral thigh flap:the oblique branch of the lateral circumflex femoral artery.Plast Reconstr Surg,2009,123(2):571-577.
3.	Wong CH,Ong YS,Wei FC.The anterolateral thigh-Vastus lateralis conjoint flap for complex defects of the lower limb.J Plast Reconstr Aesthet Surg,2012,65(2):235-239.
4.	Kekatpure VD,Trivedi NP,Shetkar G,et al.Single perforator based anterolateral thigh flap for reconstruction of large composite defects of oral cavity.Oral Oncol,2011,47(6):517-521.
5.	Yu P.Characteristics of the anterolateral thigh flap in a Western population and its application in head and neck reconstruction.Head Neck,2004,26(9):759-769.
6.	Yu P,Youssef A.Efficacy of the handheld Doppler in preoperative identification of the cutaneous perforators in the anterolateral thigh flap.Plast Reconstr Surg,2006,118(4):928-933.
7.	Kuo YR,Jeng SF,Wei FC,et al.Functional reconstruction of complex lip and cheek defects with free composite anterolateral thigh flap and vascularized fascia.Head Neck,2008,30(8):1001-1006.
8.	文根,吴旭华,柴益民,等.股前外侧皮瓣供区并发症的分析.中国修复重建外科杂志,2009,23(10):1177-1179.
9.	文根,柴益民,吴旭华,等.股前外侧皮瓣供区并发症的防治.中华显微外科杂志,2009,32(6):461-463.
10.	张春,吴恙,陈中,等.股前外侧皮瓣血管类型的临床观察与研究.中国临床解剖学杂志,2001,19(3):197-199.
11.	徐达传,阮默,张春,等.股前外侧部皮瓣的进一步解剖学研究——高位皮动脉与皮瓣血供的分型.中国临床解剖学杂志,2002,20(6):410-413.
12.	罗力生,张立宪,胡志奇.高位直接皮支型股前外侧皮瓣的应用.中国修复重建外科杂志,2001,15(4):206-207.
13.	江奕恒,李学雷,石小田,等.股前外侧单一高位穿支供血区域的形态学研究与皮瓣设计.中国临床解剖学杂志,2007,25(5):497-501.
14.	da Costa AC,Lancelotti CL.Oblique branch of the lateral circumflex femoral artery also found in 32 percent of cadavers in Brazil.Plast Reconstr Surg,2009,124(3):1011-1012.
15.	Wong CH,Kao HK,Fu B,et al.A cautionary point in the harvest of the anterolateral thigh myocutaneous flap.Ann Plast Surg,2009,62(6):637-639.
16.	Wong CH.The oblique branch trap in the harvest of the anterolateral thigh myocutaneous flap.Microsurgery,2012,32(8):631-634.
17.	Wei FC,Mardini S.Free-style free flaps.Plast Reconstr Surg,2004,114(4):910-916.
18.	Mardini S,Tsai FC,Wei FC.The thigh as a model for free style free flaps.Clin Plast Surg,2003,30(3):473-480.

1. 冯亚高,陶忠生,吕振木,等.游离股前外侧皮瓣坏死原因分析及血管变异的处理.解放军医药杂志,2013,25(7):111-112.
2. Wong CH,Wei FC,Fu B,et al.Alternative vascular pedicle of the anterolateral thigh flap:the oblique branch of the lateral circumflex femoral artery.Plast Reconstr Surg,2009,123(2):571-577.
3. Wong CH,Ong YS,Wei FC.The anterolateral thigh-Vastus lateralis conjoint flap for complex defects of the lower limb.J Plast Reconstr Aesthet Surg,2012,65(2):235-239.
4. Kekatpure VD,Trivedi NP,Shetkar G,et al.Single perforator based anterolateral thigh flap for reconstruction of large composite defects of oral cavity.Oral Oncol,2011,47(6):517-521.
5. Yu P.Characteristics of the anterolateral thigh flap in a Western population and its application in head and neck reconstruction.Head Neck,2004,26(9):759-769.
6. Yu P,Youssef A.Efficacy of the handheld Doppler in preoperative identification of the cutaneous perforators in the anterolateral thigh flap.Plast Reconstr Surg,2006,118(4):928-933.
7. Kuo YR,Jeng SF,Wei FC,et al.Functional reconstruction of complex lip and cheek defects with free composite anterolateral thigh flap and vascularized fascia.Head Neck,2008,30(8):1001-1006.
8. 文根,吴旭华,柴益民,等.股前外侧皮瓣供区并发症的分析.中国修复重建外科杂志,2009,23(10):1177-1179.
9. 文根,柴益民,吴旭华,等.股前外侧皮瓣供区并发症的防治.中华显微外科杂志,2009,32(6):461-463.
10. 张春,吴恙,陈中,等.股前外侧皮瓣血管类型的临床观察与研究.中国临床解剖学杂志,2001,19(3):197-199.
11. 徐达传,阮默,张春,等.股前外侧部皮瓣的进一步解剖学研究——高位皮动脉与皮瓣血供的分型.中国临床解剖学杂志,2002,20(6):410-413.
12. 罗力生,张立宪,胡志奇.高位直接皮支型股前外侧皮瓣的应用.中国修复重建外科杂志,2001,15(4):206-207.
13. 江奕恒,李学雷,石小田,等.股前外侧单一高位穿支供血区域的形态学研究与皮瓣设计.中国临床解剖学杂志,2007,25(5):497-501.
14. da Costa AC,Lancelotti CL.Oblique branch of the lateral circumflex femoral artery also found in 32 percent of cadavers in Brazil.Plast Reconstr Surg,2009,124(3):1011-1012.
15. Wong CH,Kao HK,Fu B,et al.A cautionary point in the harvest of the anterolateral thigh myocutaneous flap.Ann Plast Surg,2009,62(6):637-639.
16. Wong CH.The oblique branch trap in the harvest of the anterolateral thigh myocutaneous flap.Microsurgery,2012,32(8):631-634.
17. Wei FC,Mardini S.Free-style free flaps.Plast Reconstr Surg,2004,114(4):910-916.
18. Mardini S,Tsai FC,Wei FC.The thigh as a model for free style free flaps.Clin Plast Surg,2003,30(3):473-480.

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