The Combined Pedicled Anterolateral Thigh and Vastus Lateralis Flap as Filler for Complex Perineal Defects.

Details

Serval ID
serval:BIB_120253E9A292
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
The Combined Pedicled Anterolateral Thigh and Vastus Lateralis Flap as Filler for Complex Perineal Defects.
Journal
Annals of Plastic Surgery
Author(s)
di Summa P.G., Tremp M., Schwabedissen M.M.Z., Schaefer D.J., Kalbermatten D.F., Raffoul W.
ISSN
1536-3708 (Electronic)
ISSN-L
0148-7043
Publication state
Published
Issued date
2015
Peer-reviewed
Oui
Volume
75
Number
1
Pages
66-73
Language
english
Notes
Publication types: Journal ArticlePublication Status: ppublish
Abstract
Extensive defects of the pelvis and genitoperineal region are a reconstructive challenge. We discuss a consecutive series of 25 reconstructions with the pedicled anterolateral thigh (ALT) flap including muscle part of the vastus lateralis (VL) in 23 patients from October 1999 to September 2012.Only surface defects larger than 100 cm and reconstructions by composite ALT + VL were included in this retrospective analysis. Of the 23 patients, 19 underwent oncologic resection, whereas 4 cases presented Fournier gangrene. Three patients did not reach 6 months of follow-up and were excluded from further data analysis. Among the remaining 20 patients (22 reconstructions), average follow-up period was 14 months (range, 10-18 months). Patient's average age was 60 years. Average size of the defect was 182 cm.Postoperative complications included 1 (4.5%) flap necrosis out of 22 raised flaps, 1 partial flap necrosis after venous congestion, and 2 cases where a complementary reconstructive procedure was performed due to remaining defect or partial flap failure. In 6 cases, peripheral wound dehiscence (27%) was treated by debridement followed by split-thickness skin graft or advancement local flaps. Defect size was significantly related to postoperative complications and increased hospital stay, especially in those patients who underwent preoperative radiotherapy. At the end of the follow-up period, a long-term and satisfactory coverage was obtained in all patients without functional deficits.This consecutive series of composite ALT + VL flap shows that, in case of extended defects, the flap provides an excellent and adjustable muscle mass, is reliable with minimal donor-site morbidity, and can even be designed as a sensate flap.
Pubmed
Web of science
Create date
20/07/2015 10:03
Last modification date
20/08/2019 12:39
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