Abstract
INTRODUCTION: The free anterolateral thigh (ALT) skin perforator flap has gained enormous popularity as a free skin perforator flap. Currently being used for various reconstructions primarily in Asia, its routine application for soft-tissue reconstruction of the lower extremity remains unknown in the United States. The purpose of the present study was to review the current trend of flap selection for soft tissue reconstruction of the lower extremity. METHODS: We performed a retrospective review of a single-surgeon case log between 2007 and 2011 in a tertiary academic medical center. Inclusion criteria were patients who underwent free tissue transfer for lower extremity reconstruction regardless of sex or age. Exclusion criteria were limited to patients with a body mass index greater than 35 kg/m. A total of 20 patients underwent reconstruction with a free tissue transfer for soft tissue coverage of the lower extremity wound were identified. RESULTS: Fourteen free ALT and 6 free muscle flap reconstructions were performed over a 4-year period. Good reconstructive outcomes resulting in reliable soft tissue coverage were achieved in all patients. It was noted that more ALT flaps were used in the last 2 years and less muscle flaps (0/8 vs 6/12, P = 0.042) when compared with the years prior. CONCLUSIONS: Although technically more challenging to perform, the free ALT flap has recently been used significantly more for lower extremity reconstruction because of its minimal donor-site morbidity, reliable coverage, and improved contour. This represents a paradigm shift in flap selection that is being highlighted as surgical proficiency in flap dissection technique improves.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 419-422 |
| Number of pages | 4 |
| Journal | Annals of Plastic Surgery |
| Volume | 70 |
| Issue number | 4 |
| DOIs | |
| State | Published - Apr 2013 |
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Keywords
- ALT
- Anterolateral thigh flap
- Free flap
- Free tissue transfer
- Perforator flap
- Soft tissue reconstruction
ASJC Scopus subject areas
- Surgery
Cite this
Free tissue transfer to the lower extremity : A paradigm shift in flap selection for soft tissue reconstruction. / Nazerali, Rahim S.; Pu, Lee Li-Qun.
In: Annals of Plastic Surgery, Vol. 70, No. 4, 04.2013, p. 419-422.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Free tissue transfer to the lower extremity
T2 - A paradigm shift in flap selection for soft tissue reconstruction
AU - Nazerali, Rahim S.
AU - Pu, Lee Li-Qun
PY - 2013/4
Y1 - 2013/4
N2 - INTRODUCTION: The free anterolateral thigh (ALT) skin perforator flap has gained enormous popularity as a free skin perforator flap. Currently being used for various reconstructions primarily in Asia, its routine application for soft-tissue reconstruction of the lower extremity remains unknown in the United States. The purpose of the present study was to review the current trend of flap selection for soft tissue reconstruction of the lower extremity. METHODS: We performed a retrospective review of a single-surgeon case log between 2007 and 2011 in a tertiary academic medical center. Inclusion criteria were patients who underwent free tissue transfer for lower extremity reconstruction regardless of sex or age. Exclusion criteria were limited to patients with a body mass index greater than 35 kg/m. A total of 20 patients underwent reconstruction with a free tissue transfer for soft tissue coverage of the lower extremity wound were identified. RESULTS: Fourteen free ALT and 6 free muscle flap reconstructions were performed over a 4-year period. Good reconstructive outcomes resulting in reliable soft tissue coverage were achieved in all patients. It was noted that more ALT flaps were used in the last 2 years and less muscle flaps (0/8 vs 6/12, P = 0.042) when compared with the years prior. CONCLUSIONS: Although technically more challenging to perform, the free ALT flap has recently been used significantly more for lower extremity reconstruction because of its minimal donor-site morbidity, reliable coverage, and improved contour. This represents a paradigm shift in flap selection that is being highlighted as surgical proficiency in flap dissection technique improves.
AB - INTRODUCTION: The free anterolateral thigh (ALT) skin perforator flap has gained enormous popularity as a free skin perforator flap. Currently being used for various reconstructions primarily in Asia, its routine application for soft-tissue reconstruction of the lower extremity remains unknown in the United States. The purpose of the present study was to review the current trend of flap selection for soft tissue reconstruction of the lower extremity. METHODS: We performed a retrospective review of a single-surgeon case log between 2007 and 2011 in a tertiary academic medical center. Inclusion criteria were patients who underwent free tissue transfer for lower extremity reconstruction regardless of sex or age. Exclusion criteria were limited to patients with a body mass index greater than 35 kg/m. A total of 20 patients underwent reconstruction with a free tissue transfer for soft tissue coverage of the lower extremity wound were identified. RESULTS: Fourteen free ALT and 6 free muscle flap reconstructions were performed over a 4-year period. Good reconstructive outcomes resulting in reliable soft tissue coverage were achieved in all patients. It was noted that more ALT flaps were used in the last 2 years and less muscle flaps (0/8 vs 6/12, P = 0.042) when compared with the years prior. CONCLUSIONS: Although technically more challenging to perform, the free ALT flap has recently been used significantly more for lower extremity reconstruction because of its minimal donor-site morbidity, reliable coverage, and improved contour. This represents a paradigm shift in flap selection that is being highlighted as surgical proficiency in flap dissection technique improves.
KW - ALT
KW - Anterolateral thigh flap
KW - Free flap
KW - Free tissue transfer
KW - Perforator flap
KW - Soft tissue reconstruction
UR - http://www.scopus.com/inward/record.url?scp=84875448229&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84875448229&partnerID=8YFLogxK
U2 - 10.1097/SAP.0b013e31828a0c3c
DO - 10.1097/SAP.0b013e31828a0c3c
M3 - Article
VL - 70
SP - 419
EP - 422
JO - Annals of Plastic Surgery
JF - Annals of Plastic Surgery
SN - 0148-7043
IS - 4
ER -