Modified thin anterolateral thigh flaps for reconstruction of hand and foot defects

Objective To evaluate the clinical efficacy of modified thin anterolateral thigh flaps for reconstruction of hand and foot defects. Methods Between March, 2016 and September, 2017, 17 patients were reconstructed with modified thin anterolateral thigh flap. There were 6 cases for reconstruction of hand, and 3 of them were located in the back dorsal of hand defects. There were 11 cases for reconstruction of ankle and foot, and 5 of them were located in the dorsal of foot. The size of the flap was 5 cm×3 cm-33 cm×10 cm. The traditional perforator flap was elevated just above the deep fascial plane. The debulking procedures could follow before the pedicle was cut off. The modified method was that the flap was elevated from the superficial fascia and the plane between deep and superficial fat without intraoperative debulking procedures. Results Three flaps were eventually survived after secondary exploratory operation caused by the hematoma. Two flaps had partial loss, 1 of which needed secondary skin grafting, and the other flap healed with additional intention. Followed-up period was 3-18(average, 7) months . All flaps showed relatively good contour and the patients were satisfied with clinical outcomes. Conclusion It is a safe and reliable way that perforator flap can be elevated from the superficial fascia and the plane between deep and superficial fat. It can obtain a thin flap immediately and reduce donor-site morbidity without additional defatting and time-consuming. The flap is soft with good contour. This technique is an ideal option for covering defects composed of dorsal of the hand or foot and the head and neck regions. Key words: Anterolateral thigh flap; Perforator flap; Modified method of thin type flap; Microsurgical operation