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Suprafascial Anterolateral Thigh Flap Harvest: A Better Way to Minimize Donor-Site Morbidity in Head and Neck Reconstruction

Chen, Yen-Chou, M.D.; Scaglioni, Mario F., M.D.; Carrillo Jimenez, Leonardo Enrique, M.D.; Yang, Johnson Chia-Shen, M.D.; Huang, Eng-Yen, M.D.; Lin, Tsan-Shiun, M.D.

Plastic and Reconstructive Surgery: September 2016 - Volume 138 - Issue 3 - p 689-698
doi: 10.1097/PRS.0000000000002496
Reconstructive: Head and Neck: Original Articles
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Discussion

Background: The purpose of this study was to compare the clinical outcomes and donor-site morbidity between the suprafascial and subfascial harvesting of anterolateral thigh flaps.

Methods: Sixty-one patients who underwent free flap reconstruction (30 suprafascial and 31 subfascial anterolateral thigh flaps) were included in this study. The patients assessed the subjective donor-site morbidity and satisfaction with the overall functional result using a self-reported questionnaire. The flap characteristics (i.e., perforator number, flap size, and harvest time) and outcomes (i.e., success rate, partial necrosis, infection, hematoma, and fistula) were compared.

Results: The success rates of suprafascial and subfascial anterolateral thigh flaps were 96.7 and 96.8 percent, respectively. There were no significant differences in flap size, harvest time, or overall complication rates. The suprafascial anterolateral thigh flap group experienced fewer abnormal sensations (p < 0.001) and better subjective satisfaction at the donor site than did the subfascial anterolateral thigh flap group (p = 0.03).

Conclusions: In terms of reducing donor-site morbidity, the suprafascial anterolateral thigh flap group showed fewer sensory disturbances in donor thighs and exhibited better patient satisfaction than did the subfascial anterolateral thigh flap group, but meticulous dissection of tiny perforators above the fascia is required for the former procedure.

CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, III.

Kaohsiung, Taiwan; and Zurich, Switzerland

From the Departments of Plastic and Reconstructive Surgery and Radiation Oncology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine; and the Department of Plastic and Hand Surgery, University Hospital Zurich.

Received for publication September 17, 2015; accepted April 25, 2016.

Disclosure:The authors have no financial conflicts or commercial associations to disclose.

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Yen-Chou Chen, M.D., Department of Plastic and Reconstructive Surgery, Kaohsiung Chang Gung Memorial Hospital, 123 Ta-Pei Road, Niao-Sung, Kaohsiung 83301, Taiwan, chenrenslo@gmail.com

Copyright © 2016 by the American Society of Plastic Surgeons