Soft tissue defects reconstruction by anterolateral thigh flap based on the transverse branch of the lateral circumflex femoral artery
10.3760/cma.j.cn114453-20220222-00044
- VernacularTitle:以旋股外侧动脉横支为蒂的股前外侧皮瓣修复四肢皮肤软组织缺损
- Author:
Yongtao HUANG
1
;
Lin YANG
;
Junnan CHENG
;
Qinfeng GAO
;
Chengpeng YANG
;
Fengwen SUN
;
Zhijin LIU
;
Shengzhe LIU
;
Tao ZHANG
;
Jihui JU
Author Information
1. 苏州大学附属瑞华医院骨科，苏州 215104
- Keywords:
Surgical flaps;
Perforator flap;
Anterolateral thigh flap;
Transverse branch;
Lateral circumflex femoral artery;
Limbs;
Soft tissue defect
- From:
Chinese Journal of Plastic Surgery
2022;38(10):1128-1133
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the feasibility and clinical outcome of anterolateral thigh flaps (ALTF) based on the transverse branch of the lateral circumflex femoral artery (LCFA) as the source artery in the repair of soft tissue defects of the extremities.Methods:A retrospective analysis was conducted to analyze the clinical data from patients who received the ALTF pedicled with the transverse branch of the LCFA to repair the wounds of the extremities from April 2020 to March 2021 at Ruihua Affiliated Hospital of Soochow University. Preoperative Doppler ultrasound was applied to locate the perforators in the anterolateral thigh area. The ALTF was prepared based on the traditional method, and the perforators were found to be too thin to meet the requirements of vascular anastomosis. The incision was extended superiorly, and the designated perforators were found in the upper segment; thus, the flap was harvested accordingly. The ALTF pedicled with the transverse branch of the LCFA was finally harvested for wound reconstruction. The donor site was directly drawn and sutured. The wound healing of the donor site and the survival rate of the flap were recorded. The comprehensive evaluation scale was used to evaluate the repair effect, which was classified as excellent (90-100 points), good (75-89 points), fair (60-74 points), and poor (<60 points).Results:Thirteen patients with extremity trauma were enrolled in the study, which consisted of nine males and four females. The age range was between 20 and 65 years old. There were 4 cases of hand/forearm wounds and 9 cases of foot/ankle wounds among the patients. The area of soft tissue defects was approximately 7 cm×4 cm to 31 cm×8 cm. Eighteen perforators from the transverse branches of the LCFA, including ten septocutaneous perforators and eight direct cutaneous perforators, were observed in thirteen surgeries. The area of flaps ranged 8 cm×6 cm to 32 cm×10 cm. One flap exhibited arterial crisis, which was relieved after thrombectomy and re-anastomosis of the injured segment; the flap survived. Other flaps survived completely. Thirteen patients were followed up for 6-20 months, and both flaps were soft in texture and good in appearance. In addition, there were no serious complications at the donor site. Finally, the curative effects of the ALTF pedicled with the transverse branch of the LCFA were estimated according to the flap comprehensive evaluation scale. Four cases obtained excellent curative effects, seven cases had good prognoses, and the effects of the remaining two cases were acceptable.Conclusions:The ALTF pedicled with the transverse branch of the LCFA can be used to repair soft tissue defects of the extremities, with a good prognosis obtained; meanwhile, the anatomy of the perforators is simple, and the donor area is relatively inconspicuous. The flap can be a useful supplement to the conventional ALTF.
