From the "Free Tissue Transfers and Replantation" CME, December 2012. Found inside – Page 339Common free-flap options include the radial forearm flap, the jejunal flap, and, more recently, the ALT flap. Although reliable and easy to harvest, the radial forearm flap traditionally has a reputation of having high fistula rates, ... Here the lower perforator can be seen to travel through the vastus. This site needs JavaScript to work properly. Please enable it to take advantage of the complete set of features! D'Arpa S, Colebunders B, Stillaert F, Monstrey S. Clin Plast Surg. Cormack G: Anterolateral thigh flap: technical tip to facilitate elevation. The scapular flap has become clinically popular because it provides a large area of fasciocutaneous tissue and is relatively straight forward to harvest. Osteo-Septo-Cutaneous Fibula Flap Harvest from the posterior approach for mandibular reconstruction. Reconstruction: Lat. Dorsii Free Flap - ASSH 2012 Feb;21(1):107-12. Using this technique produces a good functional cosmetic outcome. BACKGROUND The anterolateral thigh (ALT) perforator flap is a popular reconstructive tissue transfer. In this article, we share our experience with achieving primary closure of 58 anterolateral thigh (ALT) free flap donor sites using a simple algorithm in cases where primary closure would otherwise have not been possible. We were able to achieve primary closure of all donor sites. Lateral Thigh and Anterolateral Thigh Free Tissue Transfer ... Keywords: However, few reports have . Koshima I, Fukuda H, Utunomiya R, Soeda S: The anterolateral thigh flap; variations in its vascular pedicle. There were no total losses and 6 partial losses; 2 were amenable to direct closure after debridement, 1 required skin graft, and 3 required a new flap for wound coverage. Surgical technique: SURGICAL ANATOMY OF THE ANTEROLATERAL THIGH FLAP The lateral circumflex femoral artery is the first branch of the profunda femoris. This site needs JavaScript to work properly. There is a need to compare the efficacy and safety of anterolateral thigh (ALT) flap and radial forearm free flap (RFFF) in head-and-neck reconstruction surgeries. Doody Rating : 3 stars : The purpose of this book is to present a modern way to treat sinonasal tumors with respect to traditional tumor extirpation principles and the need for radical excisions when the indications arise. All flaps survived with two recorded returns to theater for pedicle exploration associated with partial flap loss only. 2017 Jan;44(1):129-141. doi: 10.1016/j.cps.2016.08.004. Atlas of Surgical Techniques in Trauma The anterior lateral thigh (ALT) perforator free flap has the ability to provide either individual components or any combination of skin, fascia, and muscle to reconstruct soft tissue defects of the head and neck region. Issues in Flap Surgery The mean flap area was 261.6 cm2 (range, from 225 to 340 cm2). In well-selected patients, using our technique, several non-sizable perforators can reliably perfuse an ALT without the need to use an alternative donor si … and Koshima . Plast Reconstr Surg 107:1766, 2001. Wu JC, Huang JJ, Tsao CK, Abdelrahman M, Kolios G, Cheng MH. Unable to load your collection due to an error, Unable to load your delegates due to an error. Background: Minimizing donor-site morbidity after free flap harvest is of paramount importance. A review of 47 patients who underwent free flap reconstruction for orbital or periorbital defects between September 2006 and May 2011 was performed. Found inside – Page 407ALT - flap donor site can usually be closed directly for flaps of less than 8 to 10 cm width . ... technique and instrumentation have encouraged the development of the double - paddle ALT flap and harvesting of multiple ALT flaps from a ... Anterolateral thigh flap; Capillary perforator; Myocutaneous flap; Non-sizable perforator. 10.1055/b-0034-78129 Anterolateral Thigh FlapPao-Yuan Lin, Pouya Entezami, and Kevin C. Chung The first anterolateral thigh (ALT) flap using septocutaneous vessels was described by Song et al in 1984, and its clinical application was popularized by Koshima in 1993. Ann Plast Surg. Plast Reconstr Surg 108:1677, 2001. The aim of this book is to provide an overview of various oral diseases with emphasis on the pathogenesis, investigation, and the management protocol of different oral and maxillofacial diseases. Anterolateral Thigh Flap | Iowa Head and Neck Protocols 2021 Apr;48(2):235-248. doi: 10.1016/j.cps.2020.12.008. Sataloff's Comprehensive Textbook of Otolaryngology: Head & ... The flap can be innervated by a major branch of the lateral cutaneous nerve of the thigh. A line was drawn that joins the anterior superior iliac . A thin profunda artery perforator flap harvested from the left thigh is shown in this video. Plast Reconstr Surg 102:1517, 1998. Kimata Y, Uchiyama K, Ebihara S, Sakuraba M, Iida H, Nakatsuka T, Harii K: Anterolateral thigh flap donor-site complications and morbidity. Many of these are common and/orchronic conditions which present for initial assessment by primaryhealth care workers. Epub 2013 Nov 20. Most ALT flaps, in our experience, require dissection of musculocutaneous perforator(s) and are infrequently supplied solely by septocutaneous perforators. Grabb's Encyclopedia of Flaps - Volume 1 - Page 407 Anterolateral thigh fascial flap: the muscular fascia and pedicle are harvested, and no skin or fat is removed. Plast Reconstr Surg 106:584, 2000. Abstract. The book emphasizes the restoration of nasal defects-from simple to complex-and achieving normal appearance and function. However, Huang et al. The technique of utilizing a single gracilis functional . Atlas of Perforator Flap and Wound Healing: Microsurgical ... Plast Reconstr Surg. The mean ischemia time was 162.9 min (range, from 59 to 269 min). flap harvest. This technique can also enable the splitting of a flap when only one sizable perforator is present. Advances in flap harvest and design, vessel isolation and postoperative patient management—all initiated here in Cleveland Clinic's Head & Neck Institute—have dramatically changed this landscape. To reach the defect, it was always flap harvest and transfer. Maruccia M, Orfaniotis G, Ciudad P, Nicoli F, Cigna E, Giudice G, Kiranantawat K, Ribuffo D, Chen HC. In most cases, the descending branch distributes musculocutaneous perforators to the flap. From split thickness skin grafts to pedicled and free tissue transfer multiple techniques are at hand to restore body integrity. Sufficient soft tissue coverage allows for adjuvant radiation therapy or can cure its sequelae. Lower Extremity Reconstruction. Harvesting the chimeric ALT with a portion of vastus lateralis distally negates the need for tenuous intramuscular perforator dissection. Indications The thigh flap provides a tremendously versatile soft tissue flap. SURGICAL ANATOMY OF THE ANTEROLATERAL THIGH FLAP The lateral circumflex femoral artery is the first branch of the profunda femoris. Anteromedial thigh perforator free flap: report of 41 consecutive flaps and donor-site morbidity evaluation. Despite detachment of the majority of skin paddle from the muscle, the flap is harvested with a sleeve of areolar tissue containing preferably more than one non-sizable perforator attached to a small muscular segment of the vastus lateralis containing the pedicle. PMC To provide a description of a minimally invasive, video-assisted technique (VAT) to identify the cutaneous perforators of the anterolateral thigh (ALT). Epub 2005 Jul 25. Br J Plast Surg 42:260, 1989. It has since become a work-horse for soft tissue replacement in head and neck cancer surgery, being commonly . Using this technique produces a good functional cosmetic outcome. The anterior flap is raised and perforators are identified to the flap and spared. (AB) ascending branch Several techniques have been described to thin an ALT flap including an adipocutaneous flap, an adipofascial flap and delayed debulking.By systematically . (ALT) flap has widespread use throughout the body because of the many engineering options. INTRODUCTION. Incorporating more than one non-sizable perforator increases the reliability of the flap. Key Highlights Lower extremity soft-tissue reconstruction techniques using local muscle and perforator workhorse flaps Bone salvage and restoration techniques, including vascularized bone grafts Diabetic foot management with in-depth ... It in turn gives The anterolateral thigh flap lies on the axis of the septum dividing the vastus lateralis and the rectus femoris muscles. The book outlines techniques for flap harvest, from the most basic to the highly advanced. Accompanying the book are four supplemental DVDs that demonstrate actual operating procedures. This maximizes the number of harvestable ALTs and increases the reconstructive potential by splitting previously "un-splitable" flaps. Prevention and treatment information (HHS). Results: This book, written by leading international experts in the field, offers a comprehensive overview of the latest developments in breast reconstruction. Flap length ranged from 17 to 30 cm (mean, 25.6 cm). Lateral thigh flap The lateral thigh free flap is a fascial or fasciocutaneous flap based on the smaller vessels that extend from the profunda femoris system to the skin. RADIAL FREE FOREARM FLAP (RFFF): SURGICAL TECHNIQUE Ottie van Zyl The radial free forearm flap (RFFF) was one of the first free tissue transfer flaps to be described. Vascular Anatomy. possibility of a longer vascular pedicle on harvest. This book offers a comprehensive set of principles that lead to ideal outcomes following treatment for Head and Neck Cancers, especially in those patients who need major reconstructive procedures. Plast Reconstr Surg. Conclusion: Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. This upper perforator is useful as a lifeboat when the normal ALT perforators are inadequate. [Google Scholar] Hallock G G. The preexpanded anterolateral thigh flap. Conclusions: The ALT flap is a workhorse in covering defects of the leg . free functional gracilis myocutaneous flap in one patient, a pedicled gracilis combined with an ALT flap This book describes the reconstructive procedures currently used by the authors for the treatment of oral and maxillofacial defects, based on twenty-five years of experience at a major European University Hospital. The anterolateral thigh flap is an extremely versatile extremity flap since its moderately thick skin and large potential muscle bulk can be independently tailored to provide ideal tissue matches for this heterogeneous group of defects.
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