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Free Anterolateral Thigh Adipofascial Perforator Flap

Hsieh, Ching-Hua M.D.; Yang, Chang-Chien M.D.; Kuo, Yur-Ren M.D.; Tsai, Hui-Hong M.D.; Jeng, Seng-Feng M.D.

doi: 10.1097/01.PRS.0000076221.25738.66
Original Articles

The anterolateral thigh adipofascial flap is a vascularized flap prepared from the adipofascial layer of the anterolateral thigh region. It is a perforator flap based on septocutaneous or musculocutaneous perforators of the lateral circumflex femoral system. With methods similar to those used for the free anterolateral thigh flap, only the deep fascia of the anterolateral thigh and a 2-mm-thick to 3-mm-thick layer of subcutaneous fatty tissue above the fascia were harvested. In 11 cases, this flap (length, 5 to 11 cm; width, 4 to 8 cm) was used for successful reconstruction of extremity defects. Split-thickness skin grafts were used to immediately resurface the adipofascial flaps for eight patients, and delayed skin grafting was performed for the other three patients. The advantage of the anterolateral thigh adipofascial flap is its ability to provide vascularized, thin, pliable, gliding coverage. In addition, the donor-site defect can be closed directly. Other advantages of this flap, such as safe elevation, a long wide vascular pedicle, a large flap territory, and flow-through properties that allow simultaneous reconstruction of major-vessel and soft-tissue defects, are the same as for the conventional anterolateral thigh flap. The main disadvantage of this procedure is the need for a skin graft, with the possible complications of subsequent skin graft loss or hyperpigmentation.

Kaohsiung and Taoyuan, Taiwan

From the Departments of Plastic and Reconstructive Surgery and Neurology, Chang Gung Memorial Hospital, Chang Gung University, and the Department of Plastic and Reconstructive Surgery, Taoyuan General Hospital, Health Department, The Executive Yuan.

Received for publication October 16, 2002;

revised December 2, 2002.

Seng-Feng Jeng, M.D.

Department of Plastic and Reconstructive Surgery

Chang Gung Memorial Hospital, Kaohsiung

123 Ta-Pei Road, Niao-Sung Hsiang

Kaohsiung Hsien, Taiwan

©2003American Society of Plastic Surgeons