Abstract
Background The anterolateral thigh (ALT) flap has a key role regarding limb salvage and has
facilitated the preservation of function and esthetics in lower extremity reconstruction.
The purpose of this study is to review the advantages of the ALT flap when used early
in the reconstruction of the trauma patient; specifically, its long-term viability
when ALT flap reconstruction is followed by recurrent flap elevation performed to
allow a variety of sequential orthopedic operations including washout, antimicrobial
disc placement, and reinstrumentation.
Methods A retrospective analysis was performed to review all ALT flaps performed by the authors
from January 2009 to October 2012 at the Orlando Regional Medical Center. A total
of 69 patients with an average age of 38 years were included in the study leading
to a total of 69 ALT flaps indicated for traumatic orthopedic wounds. Out of these,
29 flaps were elevated at least once leading to a total of 49 flap elevations.
Results The median number of days to flap elevation was 117 with a minimum of 1 day and a
maximum of 540 days. A total of 42% flaps were elevated at least once after initial
placement for reinstrumentation, washout, or antibiotic disk placement. Overall, 52%
of the flaps were lifted once, 34% were lifted twice, and 14% were lifted more than
thrice. There is no statistically significant difference in the complication rate
between elevating the flap compared with primary ALT placement.
Conclusion We conclude, therefore, there is no elevated risk to long-term viability by elevating
the ALT flap. This combined with the ease of elevation makes it a safe procedure to
be performed as needed for access to the deep tissues.
Keywords
ALT - flap elevation - lower extremity trauma
