The extended approach to the vascular pedicle of the anterolateral thigh perforator flap: anatomical and clinical study

Plastic and Reconstructive Surgery
Petros K Spyriounis

Abstract

The anterolateral thigh perforator flap is a well-described and versatile flap that has specific advantages. However, the variable anatomy makes flap elevation challenging. Furthermore, the dissection of the proximal part of the pedicle that runs underneath the rectus femoris muscle demands continuous pull by an assistant and is inconvenient and tiring for the surgeon. A technique that facilitates dissection of the proximal pedicle part is suggested. It is useful in both pedicled and free flap transfer, when maximum pedicle length is crucial. Five anterolateral thigh perforator flaps were dissected using the extended technique. Four were transferred as free flaps and one as an island pedicled flap. In addition, anatomical cadaver studies were performed bilaterally in five fresh cadavers to further clarify the relevant anatomy. All flaps survived well. One patient suffered from donor-site infection caused by inadequate drainage. Conservative treatment with daily dressing changes resulted in satisfactory healing. Two patients suffered from hypesthesia of part of the lateral thigh area. No patient experienced any difficulty in daily activities and none suffered from knee extension lag. An extended approach for dissection of the an...Continue Reading

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Citations

Jul 31, 2007·Aesthetic Plastic Surgery·Umar Daraz Khan, J G Miller
Apr 12, 2008·The Journal of Trauma·Petros K Spyriounis, Barbara S Lutz
Oct 7, 2010·Indian Journal of Plastic Surgery : Official Publication of the Association of Plastic Surgeons of India·S P BharathSuraj Manjunath
Aug 31, 2011·Journal of Plastic, Reconstructive & Aesthetic Surgery : JPRAS·Petros K Spyriounis, N I Karmiris
Apr 6, 2011·Journal of Plastic, Reconstructive & Aesthetic Surgery : JPRAS·Adrienne L K LiDouglas R McKay
Sep 8, 2010·Clinics in Plastic Surgery·Peter C Neligan, Declan A Lannon
Dec 9, 2009·Journal of Plastic, Reconstructive & Aesthetic Surgery : JPRAS·Shih-Hsin ChangHung-Tao Hsiao
Aug 12, 2008·Journal of Plastic, Reconstructive & Aesthetic Surgery : JPRAS·T Agostini, V Agostini
May 20, 2008·Journal of Plastic, Reconstructive & Aesthetic Surgery : JPRAS·Lukas PrantlBernd Fuechtmeier
Nov 21, 2007·Journal of Plastic, Reconstructive & Aesthetic Surgery : JPRAS·Raymond W M NgGeorge K H Li
Aug 8, 2008·Microsurgery·Holger EngelGoetz Giessler
Apr 20, 2013·The Canadian Journal of Plastic Surgery = Journal Canadien De Chirurgie Plastique·Jessica CollinsAchilleas Thoma
Sep 15, 2012·The Journal of Craniofacial Surgery·Wanning Hu, Bing Zhang
Jul 13, 2006·Current Opinion in Otolaryngology & Head and Neck Surgery

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