Abstract

CAMPORRO-FERNANDEZ, Daniel; GARCIA-MARTINEZ, Irene; FUEYO-LLORENTE, Ángel  and  ALEGRE-FERNANDEZ, Pablo. Use of the anterolateral thigh free flap for upper-extremity reconstruction. Cir. plást. iberolatinoam. [online]. 2017, vol.43, suppl.1, pp.s63-s69. ISSN 1989-2055.

Background and Objective. The anterolateral thigh flap, since its description in 1984, has become first choice reconstructive option for large soft tissue defects. In upper extremity injuries, the recovery of function should be the main goal and a stable and premature skin coverage is mandatory to achieve this aim. We present our results in upper limb microsurgical reconstruction with anterolateral thigh flap and conduct a discussion on indications, surgical technique, and results that can contribute to its success or failure. Methods. We conduct a retrospective revision of patients treated at the Plastic Surgery Unit of the University Hospital Central de Asturias (Oviedo, España), between 2003 and 2013. We analyze flap survival, skin stability, direct closure possibility in donor site, and local and systemic postoperative complications; and we use an Spanish version of DASH questionary (Disabilities of Arm, Shoulder and Hand) to evaluate functional recover. Results. We got 15 patients treated with anterolateral thigh flap for reconstruction of upper extremity defects. High energy industrial accidents were the most frequent etiology (57%). Donor site was contralateral lower extremity contralateral to the upper injured one. Direct close was achieved in 80%. Most frequent receptor artery was radial (73.3%). Most frequent arterial anastomosis was termino-terminal. All of the venous anastomosis were termino-terminal. All the flaps survived without microsurgical incidences. DASH questionary was applied to 12 patients, and themedian punctuation for incapacity/symptoms was 25 with a range between 0 and 63. Conclusions. The ability to provide extensive skin paddles, fascia of excellent quality, a portion of vastus lateralis muscle, long vascular pedicle and reliability make the anterolateral thigh flap ideal for the treatment of complex defects of the limbs option.

Keywords : Upper extremity; Upper extremity reconstruction; Perforator flap; Anterolateral thigh free flap.

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