TITLE:
The Antero-Lateral Thigh Flap in Coverage of Extensive Post Traumatic Upper Limb Defects
AUTHORS:
Rasha Abdelkader, Hossam El Mahdy, Tamer Nagy Khairalla, Ayman Mansour, Nisar Haider Zaidi
KEYWORDS:
Anterolateral Thigh Flap, Perforator, Trauma, Defects
JOURNAL NAME:
Surgical Science,
Vol.7 No.7,
July
7,
2016
ABSTRACT: Objective: To assess the role of antero-lateral thigh flaps in coverage in
cases with traumatic injury to the upper limb. Methods: A total of fifteen cases
of upper limb trauma were studied between May 2014 and February 2016. Antero-lateral
thigh flaps were performed to cover post traumatic upper limb soft tissue defects.
Brachial interposition grafts were used in all cases. Harvesting was performed using
saphenous vein graft. A 10% larger than defect, flap was used to cover defect. Results:
The age range was 15 to 46 years. All 15 cases were male. The indication for soft
tissue reconstruction was trauma all patients. Each procedure was performed by a
“two team” approach with an experienced surgeon raising the flap and a team preparing
the recipient vessels. Flap size ranged from 15 to 25 cm in length and from 8 to
10 cm in width. Ischaemic time ranged from 91 to 157 min. We experienced a 100%
flap success rate, with good cosmesis and return to function in all cases. Only
two anastomoses required explorations or revision. Minor complications were seen
in two patients including a superficial wound infection and a small wound dehiscence.
The donor site was closed directly all cases, light dressing with slab support was
utilized in all patients Early postoperative management warming the patient, half-hourly
flap observations, and ensuring adequate hydration and urinary output. All patients
received antithrombotic therapy. Conclusion: The anterolateral thigh flap is one
of the most versatile and useful perforator flaps for multidimensional reconstructions
for head and neck, limb, trunk, and perineal region. It can be ultrathin flap for
resurfacing and filling dead spaces with superior functional and aesthetic outcomes.