Aesthetic Outcome After Reconstruction of Complex Soft Tissue Defects with Free Antero-Lateral Thigh Flap Using Simple Equipment
Journal of Surgery
Volume 3, Issue 2-1, March 2015, Pages: 36-41
Received: Feb. 7, 2015;
Accepted: Feb. 13, 2015;
Published: May 9, 2015
Views 4634 Downloads 72
Ashraf H. Abbas, Plastic Surgery Unit, Surgery Dept., Suez Canal University, Ismailia, Egypt
Moustafa Elmasry, Plastic Surgery Unit, Surgery Dept., Suez Canal University, Ismailia, Egypt and The Burn Centre Dept. of Hand and Plastic Surgery and, Dept. of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
Ingrid Steinvall, Burn Centre Department of Hand and Plastic Surgery, Linköping University, Linköping, Sweden
Osama A. Adly, Plastic Surgery Unit, Surgery Dept., Suez Canal University, Ismailia, Egypt
Mohamed A. Elbadawy, Plastic Surgery Unit, Surgery Dept., Suez Canal University, Ismailia, Egypt
Taha Ali Moati, General Surgery department, Suez Canal University, Ismailia, Egypt
Folke Sjöberg, Burn Centre Depts. of Hand, Plastic Surgery and Intensive Care and Dept. of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
Follow on us
Aim: We aimed to assess the aesthetic outcome of surgical reconstruction by free ALT flap using binocular single-refraction magnifying glasses and a modified post- operative surveillance protocol.Methods: 16 patients were operated for free antero-lateral thigh flap to reconstruct complex soft tissue defects with a close clinical follow up protocol for post operative care depending on the attending personnel in the Plastic surgery unit, Suez Canal University hospital, Ismailia, Egypt. Aesthetic outcome was assessed using a questionnaire based on Posch et al. 2005, including the following itemscolour, contour, presence of hair, overall appearance and donor site scar.Results:The patients’ assessed aesthetic outcome was acceptable in majority of the cases; median score was 4 for all assessed items. Complete flap loss occurred in one case, other complications as arterial thrombosis and hematomas and infection were detected and managed accordingly with flap salvage in the 3 complicated cases.Conclusion:The result suggests that the proposed protocol is sufficient as an alternative. The aesthetic outcome assessed by the patient and the failure rate was in line with other studies.
Free Flap Surgery, Free Antero-Lateral Thigh Flap, Binocular Single Refraction Magnifying Glasses, Aesthetic Outcome
To cite this article
Ashraf H. Abbas,
Osama A. Adly,
Mohamed A. Elbadawy,
Taha Ali Moati,
Aesthetic Outcome After Reconstruction of Complex Soft Tissue Defects with Free Antero-Lateral Thigh Flap Using Simple Equipment, Journal of Surgery. Special Issue: Postoperative Pain Syndrome.
Vol. 3, No. 2-1,
2015, pp. 36-41.
Ashraf H. Abbas, Waleed A. Ghobashy ,Amr M. Moghazy Binocular single-refraction magnifying glasses for free flap surgery: a reliable method for developing countries. Eur J PlastSurg (2012) 35:521–525.
Christopher J. Salgado, Harvey Chim, ShaylaSchoenoff, P.A.-C. and Samir Mardini,Postoperative care and monitoring of the reconstructed head and neck patient. Seminars in Plastic surgery (2010) / Vol. 24, Number. 3:281-287.
Song YG, Chen GZ, Song YL. The free thigh flap: A new free flap concept based on the septocutaneous artery. Br J PlastSurg. 1984;37:149–159.
Demirkan F, Chen HC, Wei FC et al. (2000). The versatile anterolateral thigh ﬂap: a musculocutaneousﬂap in disguise in head and neck reconstruction. British Journal of Plastic Surgery, 53: 30–36.
Kimata Y, Uchiyama K, Ebihara S et al. (1997). Versatility of the free anterolateral thigh ﬂap for reconstruction of head and neck defects. Archives of Otolaryngology, Head and Neck Surgery, 123:1325–1331.
Koshima I, Fukuda H, Yamamoto H, Moriguchi T, Soeda S, Ohta S (1993a). Free anterolateral thigh ﬂaps for reconstruction of head and neck defects. Plastic and Reconstructive Surgery, 92: 421–430,\ Koshima I, Yamamoto H, Hosoda M, Moriguchi T, Orita Y, Nagayama H (1993b). Free combined composite ﬂaps using the lateral circumﬂex femoral system for repair of massive defects of the head and neck regions: an introduction to the chimeric ﬂap principle. Plastic and Reconstructive Surgery, 92: 411–420.
Luo S, Raﬀoul W, Luo J, Gao J, Chen L, Egloﬀ DV (1999). Anterolateral thigh ﬂap; a review of 168 cases. Microsurgery, 19: 232–238.
Fu-Chan Wei, Vivekjain, NaciCelik, Hung-chi chen, David chewi-chin chuang and chih-hunglin.(2002), Have we found an ideal soft-tissue flap? An experience with 672 Anterolateral thigh flaps, PlastReconstr Surg. June 2002;2219-2226.
Abd El-hamid Abdel-khalek; Abdul-Mohsen Allam; Amgad Hendy; Sayed Abdel-Razek; HashemAyad; SobhyHweidy; HelmyShalaby and MoustafaHegazy, Clinical Evaluation of Free Anterolateral Thigh Flap in the Reconstruction of Major Soft Tissue Defects in the Leg and Foot. Egypt. J. Plast. Reconstr. Surg., Vol. 27, No. 2, July: 173-180, 2003.
Wei, F. C., Demirkan, F., Chen, H. C., et al. Double free flapsin reconstruction of extensive composite mandibular defectsin head and neck cancer. Plast. Reconstr. Surg. 103: 39, 1999.
Gabr, E., Kobayashi, M. R., Salibian, A. H., et al. Mandibularreconstruction: Are two flaps better than one? Ann. Plast.Surg. 52: 31, 2004.
Jeng, S. F., Kuo, Y. R., Wei, F. C., et al. Reconstruction of extensive composite mandibular defects with large lip involvementby using double free flaps and fascia lata grafts for oral sphincters. Plast. Reconstr. Surg. 115: 1830, 2005.
Mureau MA, Posch NA, Meeuwis CA, Hofer SO. Anterolateral thigh flap reconstruction of large external facial skin defects: a follow-up study on functional and aesthetic recipient- and donor-site outcome. Plastic and reconstructive surgery 2005; 115: 1077-1086.
Posch NA, Mureau MA, Flood SJ, Hofer SO. The combined free partial vastuslateralis with anterolateral thigh perforator flap reconstruction of extensive composite defects. British journal of plastic surgery 2005; 58: 1095-1103.
Posch NA, Mureau MA, Dumans AG, Hofer SO. Functional and aesthetic outcome and survival after double free flap reconstruction in advanced head and neck cancer patients. Plastic and reconstructive surgery 2007; 120: 124-129.