Safe dissection of the distally based anterolateral thigh flap.

Details

Serval ID
serval:BIB_015F1BD71988
Type
Article: article from journal or magazin.
Collection
Publications
Title
Safe dissection of the distally based anterolateral thigh flap.
Journal
Journal of Reconstructive Microsurgery
Author(s)
Erba P., Raffoul W., Bauquis O.
ISSN
1098-8947 (Electronic)
Publication state
Published
Issued date
2012
Volume
28
Number
6
Pages
405-412
Language
english
Notes
Publication types: Journal ArticlePublication Status: ppublish
Abstract
Background The distally based anterolateral thigh (ALT) flap is an interesting reconstructive solution for complex soft tissue defects of the knee. In spite of a low donor site morbidity and wide covering surface as well as arch of rotation, it has never gained popularity among reconstructive surgeons. Venous congestion and difficult flap dissection in the presence of a variable anatomy of the vascular pedicle are the possible reasons.Methods An anatomical study of 15 cadaver legs was performed to further clarify the blood supply of the distally based ALT. Our early experience with the use of preoperative angiography and a safe flap design modification that avoids distal intramuscular skeletonization of the vascular pedicle and includes a subcutaneous strip ranging from the distal end of the flap to the pivot point is presented.Results The distally based ALT presents a constant and reliable retrograde vascular contribution from the superior genicular artery. Preoperative angiography reliably identified and avoided critical Shieh Type II pedicled flaps. The preservation of a subcutaneous strip ranging from the distal flap end to the upper knee was associated with the absence of venous congestion in a short case series.Conclusions Preoperative angiography and a flap design modification are proposed to allow the safe transfer of the distally based ALT to reconstruct soft tissue defects of the knee.
Pubmed
Web of science
Create date
18/08/2012 11:20
Last modification date
19/02/2019 16:22
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