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Abstract
Purpose
To present the author's experience using the anterolateral thigh island flap for reconstruction of soft tissue defects around the hip and perineum.
Materials and Methods
Proximal based anterolateral thigh island flaps were performed to reconstruct the soft tissue defects at the perineum (3 patients) and the greater trochanter of the hip (one patient) in 4 patients. All patients were male. Mean age was 43 years (range, 32 to 50 years) and mean follow-up was 8 months (range, 6 to 13 months). The causes of the defects were traffic accident in 2 cases, necrotizing fasciitis 1 case, and pressure sore 1 case. Average size of the flap was 14×9 cm. Fasciocutaneous flaps were performed in 3 patients and musculocutaneous flap was performed in one patient.
Results
All flaps were survived. There were no necrosis of the flaps. One flap presented venous congestion after surgery, which resolved with the decompression of the pedicle. Reconstruction with the anterolateral thigh island flap resulted in no recurrence of the infection or ulcer and good esthetic contour.
Figures and Tables
Fig. 1
(A) Preoperative appearance of a 46-year-old man with a soft tissue defect of approximately 25×12 cm with the exposure of left scrotum in the left perineal area.
(B) Design of the flap sized 12×9 cm at ipsilateral anterolateral thigh.
(C) The flap was raised as an island flap connected to the descending branch of the lateral circumflex femoral artery. The flap was transferred to cover the perineal defect.
(D) The flap had an acceptable contour and scar around perineum at 6 months follow-up.
Fig. 2
(A) Radiograph of acetabular and displaced open pelvic fracture (Tile type C2).
(B) Soft tissue defect of a 25×15 cm in the perineal and suprapubic area was noted.
(C) The defect was covered with a 20×15 cm sized anterolateral thigh island flap.
(D) Acceptable contour and infection control around perineum was obtained after 9 months follow-up.
Fig. 3
(A) Pressure sore at the right greater trochanteric area in a paraplegia patient was noted.
(B) The island flap of 8×5 cm was raised from the right thigh and passed through a subcutaneous tunnel to cover the soft tissue defect.
(C) Two days after the operation, the venous congestion was noticed. The decompression of the vascular pedicle was done to resolve the venous insufficiency.
(D) The appearance of the flap 6 months after surgery.
References
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