medigraphic.com
ISSN 2992-8559 (Electronic)
ISSN 1405-0625 (Print)

2025, Number 4

<< Back Next >>

Cir Plast 2025; 35 (4)

Modification to the technique of anterolateral thigh flaps improving surgical times

Saldívar-Reyes DA, San MA, González-Cantú CM, González-Martínez CA

Language: Spanish
References: 10
Page: 181-186
PDF size: 3969.88 Kb.


ABSTRACT

The anterolateral thigh flap (ALT) is widely used in reconstructive surgery, although its dissection may be prolonged due to anatomical variations and Doppler use. The purpose of this treatment is to reduce surgical time and design the skin island according to the defect size required. We conducted a retrospective study of five patients operated between 2023 and 2025, who underwent reconstruction with ALT flaps using a modified technique: lateral incision without Doppler marking, direct dissection towards the pedicle and transoperative design of the cutaneous island. Five men between the ages of 23 and 54 years-old were included. No complications were reported. In three cases, grafting was required in the donor area, while in two cases, primary closure was achieved. The technique showed a reduction in operating times and facilitated flap design. We conclude that the modified ALT flap technique shortens surgical times without compromising safety. The preoperative Doppler is not essential, and the cutaneous island can be designed individually during surgery.


REFERENCES

  1. Graboyes EM, Hornig JD. Evolution of the anterolateral thigh free flap. Curr Opin Otolaryngol Head Neck Surg 2017; 25 (5): 416-421.

  2. Onuma H, Fuse Y, Karakawa R, Yano T, Yoshimatsu H. The pedicled anterolateral thigh flap for donor site closure after a large superficial circumflex iliac artery perforator flap harvest. Plast Reconstr Surg Glob Open 2023; 11 (7): e5115.

  3. Thomas B, Haug V, Falkner F, Arras C, Nagel SS, Boecker A et al. A single-center retrospective comparison of Duplex ultrasonography versus audible Doppler regarding anterolateral thigh perforator flap harvest and operative times. Microsurgery 2022; 42 (1): 40-49.

  4. Bali ZU, Aksoy A, Tuluy Y, Parspanci A, Keçeci Y, Yoleri L. New approach for superthin anterolateral thigh flap elevation. Ann Plast Surg 2023; 91 (2): 232-237.

  5. Smit JM, Klein S, Werker PMN. An overview of methods for vascular mapping in the planning of free flaps. J Plast Reconstr Aesthet Surg 2010; 63 (9): e674-e682.

  6. Chakraborty SS, Malhotra A, Urvi Ashok S, Baraiya D, Shetty SP, Babu SR et al. Comparison of the free thinned anterolateral thigh perforator flap with the free medial sural artery perforator flap for reconstruction of head and neck, and extremity defects. Pol Przegl Chir 2023; 95 (4): 1-5.

  7. Xie RG. Medial versus lateral approach to harvesting of anterolateral thigh flap. J Int Med Res 2018; 46 (11): 4569-4577.

  8. Kim JS, Lee HH, Koh SH, Lee DC, Roh SY, Lee KJ. Hand reconstruction using anterolateral thigh free flap by terminal perforator-to-digital artery anastomosis: retrospective analysis. Arch Plast Surg 2024; 51 (1): 87-93. doi: 10.1055/a-2161-7419.

  9. Piper ML, Stranix JT, Bast JH, Kovach SJ. A bipedicled flap for closure of the anterolateral thigh flap donor site. Plast Reconstr Surg Glob Open 2020; 8 (8): e2770.

  10. Agostini T, Lazzeri D, Spinelli G. Anterolateral thigh flap thinning: techniques and complications. Ann Plast Surg 2014; 72 (2): 246-252.




2020     |     www.medigraphic.com