Open Access
CC BY 4.0 · Arch Plast Surg 2023; 50(06): 601-609
DOI: 10.1055/s-0043-1772586
Extremity/Lymphedema
Original Article

Comparison of The Thickness of Free Anterolateral Thigh Flap in Different Fascial Planes: Clinical Results of Subfascial and Superficial Fat Flap

Yavuz Tuluy 
,
Zülfükar Ulaş Bali 
2   Plastic, Reconstructive and Aesthetic Surgery, İstanbul, Turkey
,
Merve Özkaya Ünsal 
3   Department of Plastic, Reconstructive and Aesthetic Surgery, İzmir, Turkey
,
Aziz Parspancı 
4   Department of Plastic Reconstructive and Aesthetic Surgery, Bayburt State Hospital, Bayburt, Turkey
,
Levent Yoleri 
5   Department of Plastic Reconstructive and Aesthetic Surgery, Manisa Celal Bayar University Faculty of Medicine, Manisa, Turkey
,
Çağla Çiçek 
6   Department of Plastic Reconstructive and Aesthetic Surgery, İstanbul Kartal Dr. Lütfi Kırdar City Hospital, İstanbul, Turkey
,
Gaye Taylan Filinte 
6   Department of Plastic Reconstructive and Aesthetic Surgery, İstanbul Kartal Dr. Lütfi Kırdar City Hospital, İstanbul, Turkey
› Author Affiliations
Funding None.
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Abstract

Background The anterolateral thigh (ALT) flap is a preferred option in the reconstruction of a wide variety of defects, enabling multiple tissue components and thicknesses.

Methods This study was conducted to investigate the correlation of the thickness of the traditional subfascial ALT flap and superficial fat flap with age, gender, and body mass index (BMI). A total of 42 patients (28 males and 14 females) were included in the study.

Results Mean age was 50.2 (range, 16–75) years and mean BMI was 24.68 ± 4.02 (range, 16.5–34.7) kg/m2. The subfascial flap thickness was significantly thinner in male patients (16.07 ± 2.77 mm) than in female patients (24.07 ± 3.93 mm; p < 0.05), whereas no significant difference was found between male (4.28 ± 1.15 mm) and female patients (4.85 ± 1.09 mm) regarding superficial fat flap thickness (p = 0.13). The thickness of both flaps had a positive correlation with BMI, and the strongest correlation was found for subfascial ALT thickness in female patients (r = 0.81). Age had no effect on both flap thickness measurements. The anterior thigh is thicker in women than in men, although it varies according to BMI. This shows that flap elevation is important in the superthin plane, especially if a thin flap is desired in female patients in defect reconstruction with the ALT flap. Thus, a single-stage reconstruction is achieved without the need for a defatting procedure after subfascial dissection or a second defatting procedure 3 to 6 months later.

Conclusion The appropriate ALT flap plane should be selected considering the gender and BMI of the patient.

Keywords

anterolateral thigh flap - reconstruction - free flap - superficial fat flap

Authors' Contributions

Y.T., Z.U.B., M.Ü.Ö., A.P., and Ç.Ç. contributed to the conception and surgical procedure, data collection, manuscript writing, and interpretation of data. L.Y. and G.T.F. contributed to the conception, data collection, and interpretation of data.


Ethical Approval

The study was approved by İstanbul Kartal Dr. Lütfi Kırdar Educational and Training Hospital Institutional Review Board (approval no.: 514/194/9).


Patient Consent

Informed consent forms were obtained from the patients for the operation, use of data, and photographs.




Publication History

Received: 20 December 2022

Accepted: 29 June 2023

Article published online:
01 December 2023

© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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