DESIGN AND APPLICATION OF ANTEROLATERAL THIGH FREE FLAP WITH OBLIQUE BRANCH

Objective: To investigate the feasibility of the anterolateral thigh free flap with the oblique branch in reconstructing the soft tissue defects of lower extremity.

Methods: Between June 2009 and February 2013, 12 patients (including 7 males and 5 females) with soft tissue defects of lower extremity were treated with the anterolateral thigh free flap with the oblique branch, aged from 8 to 42 years (median, 32 years). The locations of soft tissue defect were the dorsum of the foot in 5 cases, the ankle and foot in 4 cases, the lower leg in 2 cases, and the distal foot in 1 case. All defects were associated with exposure of tendon and bone. The size of the wound was from 15 cm x 7 cm to 27 cm x 12 cm. The interval of injury and operation was 1 to 7 days (mean, 3.7 days). The anterolateral thigh flap was pedicled with only the oblique branch in 7 patients, and with the both descending branch and oblique branch in 5 patients, and the size of flap was from 17 cm x 9 cm to 30 cm x 15 cm. The donor sites were repaired by suture in 3 patients, and by skin graft in 9 patients.

Results: Distal skin flap necrosis occurred in 1 case, and was cured after dressing change and skin graft. The other flaps survived, and the donor site healed primarily. The follow-up time was from 10 months to 2 years (mean, 18 months). Thinning operation was performed in 3 cases, and the other flaps recovered pain and warm sensation with good appearance.

Conclusions: It is a safe and effective method to reconstruct soft tissue defects of the lower extremity with the anterolateral thigh flap pedicled with the oblique branch.