Versatile application of pedicled anterolateral thigh flaps in reconstruction

Yuan-Sheng Tzeng, Shun-Cheng Chang, Niann-Tzyy Dai, Shou-Cheng Deng, Chih-Hsin Wang, Tim-Mo Chen, Shyi-Gen Chen

Research output: Contribution to journalArticle

Abstract

Background: Reconstruction of extensive defects of the lower abdomen, trochanter, groin and knee without using complex microsurgery is a reconstructive challenge. Pedicled anterolateral thigh (ALT) flaps offer many advantages over other regional flaps for this purpose, such as the large skin area and soft-tissue availability, a remarkable pedicle length, and possessing multiple components and reliability. We present our experience of using pedicled ALT flaps for repairing various defects. Methods: From September 2006 to October 2012, 32 pedicled ALT flaps were used in 31 patients for defects of the lower abdomen (3 patients), trochanter (26 patients), groin (1 patient) and knee (1 patient). Eighteen of the patients were male (58%) and the age ranged from 22 to 103 years. The flap size ranged from 8×5 cm (40 cm2) to 9×20 cm (180 cm2). Results: Satisfactory coverage was achieved in all patients. Conclusions: Our experience has shown the wide arc of rotation, large skin replacement potential, multiple components and reliability of pedicled ALT flaps. © 2013 JMS.
Original languageEnglish
Pages (from-to)177-182
Number of pages6
JournalJournal of Medical Sciences (Taiwan)
Volume33
Issue number4
DOIs
Publication statusPublished - 2013
Externally publishedYes

Fingerprint

Thigh
Groin
Abdomen
Femur
Knee
Skin
Microsurgery

Keywords

  • Anterolateral thigh flap
  • Groin defect
  • Knee defect
  • Lower abdominal defect
  • Pedicled flap
  • abdominal injury
  • adult
  • aged
  • anterolateral thigh flap
  • article
  • bladder rupture
  • clinical article
  • cystostomy
  • debridement
  • decubitus
  • female
  • follow up
  • hip injury
  • human
  • inguinal region
  • knee injury
  • male
  • outcome assessment
  • patient satisfaction
  • pedicled skin flap
  • pelvis fracture
  • prosthesis infection
  • skin defect
  • skin island flap
  • surgical approach
  • wound healing

Cite this

Versatile application of pedicled anterolateral thigh flaps in reconstruction. / Tzeng, Yuan-Sheng; Chang, Shun-Cheng; Dai, Niann-Tzyy; Deng, Shou-Cheng; Wang, Chih-Hsin; Chen, Tim-Mo; Chen, Shyi-Gen.

In: Journal of Medical Sciences (Taiwan), Vol. 33, No. 4, 2013, p. 177-182.

Research output: Contribution to journalArticle

Tzeng, Yuan-Sheng ; Chang, Shun-Cheng ; Dai, Niann-Tzyy ; Deng, Shou-Cheng ; Wang, Chih-Hsin ; Chen, Tim-Mo ; Chen, Shyi-Gen. / Versatile application of pedicled anterolateral thigh flaps in reconstruction. In: Journal of Medical Sciences (Taiwan). 2013 ; Vol. 33, No. 4. pp. 177-182.
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title = "Versatile application of pedicled anterolateral thigh flaps in reconstruction",
abstract = "Background: Reconstruction of extensive defects of the lower abdomen, trochanter, groin and knee without using complex microsurgery is a reconstructive challenge. Pedicled anterolateral thigh (ALT) flaps offer many advantages over other regional flaps for this purpose, such as the large skin area and soft-tissue availability, a remarkable pedicle length, and possessing multiple components and reliability. We present our experience of using pedicled ALT flaps for repairing various defects. Methods: From September 2006 to October 2012, 32 pedicled ALT flaps were used in 31 patients for defects of the lower abdomen (3 patients), trochanter (26 patients), groin (1 patient) and knee (1 patient). Eighteen of the patients were male (58{\%}) and the age ranged from 22 to 103 years. The flap size ranged from 8×5 cm (40 cm2) to 9×20 cm (180 cm2). Results: Satisfactory coverage was achieved in all patients. Conclusions: Our experience has shown the wide arc of rotation, large skin replacement potential, multiple components and reliability of pedicled ALT flaps. {\circledC} 2013 JMS.",
keywords = "Anterolateral thigh flap, Groin defect, Knee defect, Lower abdominal defect, Pedicled flap, abdominal injury, adult, aged, anterolateral thigh flap, article, bladder rupture, clinical article, cystostomy, debridement, decubitus, female, follow up, hip injury, human, inguinal region, knee injury, male, outcome assessment, patient satisfaction, pedicled skin flap, pelvis fracture, prosthesis infection, skin defect, skin island flap, surgical approach, wound healing",
author = "Yuan-Sheng Tzeng and Shun-Cheng Chang and Niann-Tzyy Dai and Shou-Cheng Deng and Chih-Hsin Wang and Tim-Mo Chen and Shyi-Gen Chen",
note = "Export Date: 21 March 2016 通訊地址: Chen, S.-G.; Division of Plastic Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, No. 325, Sec. 2, Cheng-gong Road, Taipei 114, Taiwan; 電子郵件: m6246kimo@yahoo.com.tw 參考文獻: Song, Y.G., Chen, G.Z., Song, Y.L., The free thigh flap: A new free flap concept based on the septocutaneous artery (1984) Br J Plast Surg, 37, pp. 149-159; Koshima, I., Nanba, Y., Tsutui, T., Takahashi, Y., Itoh, S., Perforator flaps in lower extremity reconstruction (2002) Handchir Mikrochir Plast Chir, 34, pp. 251-256; Wei, F.C., Jain, V., Celik, N., Chen, H.C., Chuang, D.C., Lin, C.H., Have we found an ideal soft-tissue flap? An experience with 672 anterolateral thigh flaps (2002) Plast Reconstr Surg, 109, pp. 2219-2226; Koshima, I., Tai, T., Yamasaki, M., One-stage reconstruction of the penis using an innervated radial forearm osteocutaneous flap (1986) J Reconstr Microsurg, 3, pp. 19-26; Tzeng, Y.S., Yu, C.C., Chou, T.D., Chen, T.M., Chen, S.G., Proximal pedicled anterolateral thigh flap for reconstruction of trochanteric defect (2008) Ann Plast Surg, 61, pp. 79-82. , doi: 10.1097/SAP.0b013e318151fb5b; Wang, C.H., Chen, S.Y., Fu, J.P., Dai, N.T., Chen, S.L., Chen, T.M., Chen, S.G., Reconstruction of trochanteric pressure sores with pedicled anterolateral thigh myocutaneous flaps (2011) J Plast Reconstr Aesthet Surg, 64, pp. 671-676. , doi: 10.1016/j.bjps.2010.08.042; Lin, C.T., Chen, S.G., Chen, T.M., Fu, J.P., Reconstruction of a large abdominal wall defect by using a pedicled vastus lateralis muscle flap: A case report and literature review (2011) J Med Sci, 31, pp. 279-282. , doi:10.6136/JMS.2011.31(6).279; Ou, K.W., Wei, L.G., Chen, S.I., Chen, S.G., Reverse anterolateral thigh flap for salvage of infected and exposed knee prostheses-a case report and review of the literature (2012) J Taiwan Soc of Plast Surg, 21, pp. 158-163; Luo, S., Raffoul, W., Piaget, F., Egloff, D.V., Anterolateral thigh fasciocutaneous flap in the difficult perineogenital reconstruction (2000) Plast Reconstr Surg, 105, pp. 171-173; Ahmad, Q.G., Reddy, M., Shetty, K.P., Prasad, R., Hosi, J.S., Bhathena, M., Groin reconstruction by anterolateral thigh flap: A review of 16 cases (2004) Indian J Plast Surg, 37, pp. 34-39; Evriviades, D., Raurell, A., Perks, G.B., Pedicled anterolateral thigh flap for reconstruction after radical groin dissection (2007) Urology, 70, pp. 996-999; Kimata, Y., Uchiyama, K., Sekido, M., Sakuraba, M., Iida, H., Nakatsuka, T., Harii, K., Anterolateral thigh flap for abdominal wall reconstruction (1999) Plast Reconstr Surg, 103, pp. 1191-1197; Chang, S.H., Anterolateral thigh island pedicled flap in trochanteric pressure sore reconstruction (2007) J Plast Reconstr Aesthet Surg, 60, pp. 1074-1075; Cunha-Gomes, D., Bembde, R., Bhathena, H., Kavarana, N.M., The pedicled anterolateral thigh island flap for inguinal defects (2000) Eur J Plast Surg, 23, pp. 97-100; Cunha-Gomes, D., Bhathena, H., Kavarana, N.M., The anterolateral thigh flap: A versatile pedicled and free flap transfer (2001) Eur J Plast Surg, 24, pp. 80-84; Gravvanis, A.I., Tsoutsos, D.A., Karakitsos, D., Panayotou, P., Iconomou, T., Zografos, G., Karabinis, A., Papadopoulos, O., Application of the pedicled anterolateral thigh flap to defects from the pelvis to the knee (2006) Microsurgery, 26, pp. 432-438; Hsieh, C.H., Huang, K.F., Jeng, S.F., Tsai, H.H., Yang, J.C., Chiang, Y.C., Reconstruction of open pelvic fracture skin defect with an anterolateral thigh island flap: A case report (2007) J Trauma, 62, pp. 1277-1280; Lee, J.T., Cheng, L.F., Lin, C.M., Wang, C.H., Huang, C.C., Chien, S.H., A new technique of transferring island pedicled anterolateral thigh and vastus lateralis myocutaneous flaps for reconstruction of recurrent ischial pressure sores (2007) J Plast Reconstr Aesthet Surg, 60, pp. 1060-1066; Ng, R.W., Chan, J.Y., Mok, V., A modification of technique to cover a large posterior thigh defect using an anterolateral thigh flap (2008) Ann Plast Surg, 61, pp. 201-203. , doi: 10.1097/SAP.0b013e318158a013; Ng, R.W., Chan, J.Y., Mok, V., Li, G.K., Clinical use of a pedicled anterolateral thigh flap (2008) J Plast Reconstr Aesthet Surg, 61, pp. 158-164; Rees, L., Moses, M., Clibbon, J., The anterolateral thigh (ALT) flap in reconstruction following radical excision of groin and vulval hidradenitis suppurativa (2007) J Plast Reconstr Aesthet Surg, 60, pp. 1363-1365; Wang, X., Qiao, Q., Burd, A., Liu, Z., Zhao, R., Wang, C., Zeng, A., Perineum reconstruction with pedicled anterolateral thigh fasciocutaneous flap (2006) Ann Plast Surg, 56, pp. 151-155; Nahai, F., Silverton, J.S., Hill, H.L., Vasconez, L.O., The tensor fasciae latae musculocutaneous flap (1978) Ann Plast Surg, 1, pp. 372-379; Friji, M.T., Suri, M.P., Shankhdhar, V.K., Ahmad, Q.G., Yadav, P.S., Pedicled anterolateral thigh flap: A versatile flap for difficult regional soft tissue reconstruction (2010) Ann Plast Surg, 64, pp. 458-461. , doi: 10.1097/ SAP.0b013e3181b4bc70",
year = "2013",
doi = "10.6136/JMS.2013.33(4).177",
language = "English",
volume = "33",
pages = "177--182",
journal = "Journal of Medical Sciences",
issn = "1011-4564",
publisher = "國防醫學院",
number = "4",

}

TY - JOUR

T1 - Versatile application of pedicled anterolateral thigh flaps in reconstruction

AU - Tzeng, Yuan-Sheng

AU - Chang, Shun-Cheng

AU - Dai, Niann-Tzyy

AU - Deng, Shou-Cheng

AU - Wang, Chih-Hsin

AU - Chen, Tim-Mo

AU - Chen, Shyi-Gen

N1 - Export Date: 21 March 2016 通訊地址: Chen, S.-G.; Division of Plastic Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, No. 325, Sec. 2, Cheng-gong Road, Taipei 114, Taiwan; 電子郵件: m6246kimo@yahoo.com.tw 參考文獻: Song, Y.G., Chen, G.Z., Song, Y.L., The free thigh flap: A new free flap concept based on the septocutaneous artery (1984) Br J Plast Surg, 37, pp. 149-159; Koshima, I., Nanba, Y., Tsutui, T., Takahashi, Y., Itoh, S., Perforator flaps in lower extremity reconstruction (2002) Handchir Mikrochir Plast Chir, 34, pp. 251-256; Wei, F.C., Jain, V., Celik, N., Chen, H.C., Chuang, D.C., Lin, C.H., Have we found an ideal soft-tissue flap? An experience with 672 anterolateral thigh flaps (2002) Plast Reconstr Surg, 109, pp. 2219-2226; Koshima, I., Tai, T., Yamasaki, M., One-stage reconstruction of the penis using an innervated radial forearm osteocutaneous flap (1986) J Reconstr Microsurg, 3, pp. 19-26; Tzeng, Y.S., Yu, C.C., Chou, T.D., Chen, T.M., Chen, S.G., Proximal pedicled anterolateral thigh flap for reconstruction of trochanteric defect (2008) Ann Plast Surg, 61, pp. 79-82. , doi: 10.1097/SAP.0b013e318151fb5b; Wang, C.H., Chen, S.Y., Fu, J.P., Dai, N.T., Chen, S.L., Chen, T.M., Chen, S.G., Reconstruction of trochanteric pressure sores with pedicled anterolateral thigh myocutaneous flaps (2011) J Plast Reconstr Aesthet Surg, 64, pp. 671-676. , doi: 10.1016/j.bjps.2010.08.042; Lin, C.T., Chen, S.G., Chen, T.M., Fu, J.P., Reconstruction of a large abdominal wall defect by using a pedicled vastus lateralis muscle flap: A case report and literature review (2011) J Med Sci, 31, pp. 279-282. , doi:10.6136/JMS.2011.31(6).279; Ou, K.W., Wei, L.G., Chen, S.I., Chen, S.G., Reverse anterolateral thigh flap for salvage of infected and exposed knee prostheses-a case report and review of the literature (2012) J Taiwan Soc of Plast Surg, 21, pp. 158-163; Luo, S., Raffoul, W., Piaget, F., Egloff, D.V., Anterolateral thigh fasciocutaneous flap in the difficult perineogenital reconstruction (2000) Plast Reconstr Surg, 105, pp. 171-173; Ahmad, Q.G., Reddy, M., Shetty, K.P., Prasad, R., Hosi, J.S., Bhathena, M., Groin reconstruction by anterolateral thigh flap: A review of 16 cases (2004) Indian J Plast Surg, 37, pp. 34-39; Evriviades, D., Raurell, A., Perks, G.B., Pedicled anterolateral thigh flap for reconstruction after radical groin dissection (2007) Urology, 70, pp. 996-999; Kimata, Y., Uchiyama, K., Sekido, M., Sakuraba, M., Iida, H., Nakatsuka, T., Harii, K., Anterolateral thigh flap for abdominal wall reconstruction (1999) Plast Reconstr Surg, 103, pp. 1191-1197; Chang, S.H., Anterolateral thigh island pedicled flap in trochanteric pressure sore reconstruction (2007) J Plast Reconstr Aesthet Surg, 60, pp. 1074-1075; Cunha-Gomes, D., Bembde, R., Bhathena, H., Kavarana, N.M., The pedicled anterolateral thigh island flap for inguinal defects (2000) Eur J Plast Surg, 23, pp. 97-100; Cunha-Gomes, D., Bhathena, H., Kavarana, N.M., The anterolateral thigh flap: A versatile pedicled and free flap transfer (2001) Eur J Plast Surg, 24, pp. 80-84; Gravvanis, A.I., Tsoutsos, D.A., Karakitsos, D., Panayotou, P., Iconomou, T., Zografos, G., Karabinis, A., Papadopoulos, O., Application of the pedicled anterolateral thigh flap to defects from the pelvis to the knee (2006) Microsurgery, 26, pp. 432-438; Hsieh, C.H., Huang, K.F., Jeng, S.F., Tsai, H.H., Yang, J.C., Chiang, Y.C., Reconstruction of open pelvic fracture skin defect with an anterolateral thigh island flap: A case report (2007) J Trauma, 62, pp. 1277-1280; Lee, J.T., Cheng, L.F., Lin, C.M., Wang, C.H., Huang, C.C., Chien, S.H., A new technique of transferring island pedicled anterolateral thigh and vastus lateralis myocutaneous flaps for reconstruction of recurrent ischial pressure sores (2007) J Plast Reconstr Aesthet Surg, 60, pp. 1060-1066; Ng, R.W., Chan, J.Y., Mok, V., A modification of technique to cover a large posterior thigh defect using an anterolateral thigh flap (2008) Ann Plast Surg, 61, pp. 201-203. , doi: 10.1097/SAP.0b013e318158a013; Ng, R.W., Chan, J.Y., Mok, V., Li, G.K., Clinical use of a pedicled anterolateral thigh flap (2008) J Plast Reconstr Aesthet Surg, 61, pp. 158-164; Rees, L., Moses, M., Clibbon, J., The anterolateral thigh (ALT) flap in reconstruction following radical excision of groin and vulval hidradenitis suppurativa (2007) J Plast Reconstr Aesthet Surg, 60, pp. 1363-1365; Wang, X., Qiao, Q., Burd, A., Liu, Z., Zhao, R., Wang, C., Zeng, A., Perineum reconstruction with pedicled anterolateral thigh fasciocutaneous flap (2006) Ann Plast Surg, 56, pp. 151-155; Nahai, F., Silverton, J.S., Hill, H.L., Vasconez, L.O., The tensor fasciae latae musculocutaneous flap (1978) Ann Plast Surg, 1, pp. 372-379; Friji, M.T., Suri, M.P., Shankhdhar, V.K., Ahmad, Q.G., Yadav, P.S., Pedicled anterolateral thigh flap: A versatile flap for difficult regional soft tissue reconstruction (2010) Ann Plast Surg, 64, pp. 458-461. , doi: 10.1097/ SAP.0b013e3181b4bc70

PY - 2013

Y1 - 2013

N2 - Background: Reconstruction of extensive defects of the lower abdomen, trochanter, groin and knee without using complex microsurgery is a reconstructive challenge. Pedicled anterolateral thigh (ALT) flaps offer many advantages over other regional flaps for this purpose, such as the large skin area and soft-tissue availability, a remarkable pedicle length, and possessing multiple components and reliability. We present our experience of using pedicled ALT flaps for repairing various defects. Methods: From September 2006 to October 2012, 32 pedicled ALT flaps were used in 31 patients for defects of the lower abdomen (3 patients), trochanter (26 patients), groin (1 patient) and knee (1 patient). Eighteen of the patients were male (58%) and the age ranged from 22 to 103 years. The flap size ranged from 8×5 cm (40 cm2) to 9×20 cm (180 cm2). Results: Satisfactory coverage was achieved in all patients. Conclusions: Our experience has shown the wide arc of rotation, large skin replacement potential, multiple components and reliability of pedicled ALT flaps. © 2013 JMS.

AB - Background: Reconstruction of extensive defects of the lower abdomen, trochanter, groin and knee without using complex microsurgery is a reconstructive challenge. Pedicled anterolateral thigh (ALT) flaps offer many advantages over other regional flaps for this purpose, such as the large skin area and soft-tissue availability, a remarkable pedicle length, and possessing multiple components and reliability. We present our experience of using pedicled ALT flaps for repairing various defects. Methods: From September 2006 to October 2012, 32 pedicled ALT flaps were used in 31 patients for defects of the lower abdomen (3 patients), trochanter (26 patients), groin (1 patient) and knee (1 patient). Eighteen of the patients were male (58%) and the age ranged from 22 to 103 years. The flap size ranged from 8×5 cm (40 cm2) to 9×20 cm (180 cm2). Results: Satisfactory coverage was achieved in all patients. Conclusions: Our experience has shown the wide arc of rotation, large skin replacement potential, multiple components and reliability of pedicled ALT flaps. © 2013 JMS.

KW - Anterolateral thigh flap

KW - Groin defect

KW - Knee defect

KW - Lower abdominal defect

KW - Pedicled flap

KW - abdominal injury

KW - adult

KW - aged

KW - anterolateral thigh flap

KW - article

KW - bladder rupture

KW - clinical article

KW - cystostomy

KW - debridement

KW - decubitus

KW - female

KW - follow up

KW - hip injury

KW - human

KW - inguinal region

KW - knee injury

KW - male

KW - outcome assessment

KW - patient satisfaction

KW - pedicled skin flap

KW - pelvis fracture

KW - prosthesis infection

KW - skin defect

KW - skin island flap

KW - surgical approach

KW - wound healing

U2 - 10.6136/JMS.2013.33(4).177

DO - 10.6136/JMS.2013.33(4).177

M3 - Article

VL - 33

SP - 177

EP - 182

JO - Journal of Medical Sciences

JF - Journal of Medical Sciences

SN - 1011-4564

IS - 4

ER -