J Reconstr Microsurg 2018; 34(07): 465-471
DOI: 10.1055/s-0038-1639366
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Alternative Choices for Anterolateral Thigh Flaps Lacking Suitable Perforators: A Systematic Review

Sik Namgoong
1   Department of Plastic Surgery, Korea University Guro Hospital, Seoul, Republic of Korea
,
Young Don Yoon
1   Department of Plastic Surgery, Korea University Guro Hospital, Seoul, Republic of Korea
,
Ki Hyun Yoo
1   Department of Plastic Surgery, Korea University Guro Hospital, Seoul, Republic of Korea
,
Seung Kyu Han
1   Department of Plastic Surgery, Korea University Guro Hospital, Seoul, Republic of Korea
,
Woo Kyung Kim
1   Department of Plastic Surgery, Korea University Guro Hospital, Seoul, Republic of Korea
,
Eun Sang Dhong
1   Department of Plastic Surgery, Korea University Guro Hospital, Seoul, Republic of Korea
› Author Affiliations
Funding None.
Further Information

Publication History

17 July 2017

30 January 2018

Publication Date:
01 April 2018 (online)

Abstract

Background The anterolateral thigh (ALT) flap has become a predominant option in the field of reconstruction. However, some difficulties in harvesting flap exist due to the anatomical variability of the perforators. Reports have provided solutions for unreliable perforators. Although numerous cases that showed successful conversion to tensor fasciae latae (TFL) flap or anteromedial thigh (AMT) flap have been reported in the literature, none fully addresses the reliability of the perforators that have been described to date. Therefore, we conducted a systematic literature review to compare the reliability of the TFL flap with that of the AMT flap when an ALT flap perforator is not suitable.

Methods A systematic review of the MEDLINE, PubMed, and Cochrane Library electronic databases was performed to compare the characteristics of TFL and AMT flap perforators.

Results A total of 13 articles were included for review. The mean number of TFL perforators varied from 1.41 to 3.17 per thigh. The mean number of AMT perforators was between 0.59 and 1.3 per thigh. The cumulative assessment of the clinical and anatomical studies showed 456 perforators in 180 TFL flaps (mean, 2.53) and 145 perforators in 162 AMT flaps (mean, 0.90). The mean pedicle length of the TFL and AMT flaps ranged from 7.0 to 9.59 cm and from 7.4 to 11.0 cm, respectively. The mean perforator diameter was similar in both flaps.

Conclusion Currently available literature suggests that the TFL flap may be a more reliable alternative when adequate perforators are not found for ALT flap harvest.

Supplementary Material

 
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