Objective: To investigate the donor-site complications of the anterolateral thigh flap and its influencing factors.
Methods: Between July 1988 and July 2007, 427 patients were treated with anterolateral thigh flap. Among them, 33 patients had postoperative donor-site complications and their clinical data were analyzed retrospectively. There were 21 males and 12 females aged 14-47 years old (average 32.7 years old). The size of the wound defect ranged from 16 cm x 7 cm to 28 cm x 13 cm. The area of the flap harvested during operation ranged from 16 cm x 7 cm to 30 cm x 13 cm. The donor sites were treated by direct suture in 7 cases; free split-thickness skin graft in 23 cases, and reverse superficial epigastric artery flap repair in 3 cases. The size of graft in the donor site ranged from 10 cm x 5 cm to 18 cm x 8 cm. The occurrence of short-term (within 4 weeks) and long-term (over 6 months) complications were analyzed.
Results: All patients were followed up for 8-54 months (average 21 months). There were 26 patients (78.8%) with short-term and long-term complications and 7 patients (21.2%) with long-term complications. The short-term complications included skin graft necrosis in 23 cases (69.7%), wound infection in 17 cases (51.5%), and muscle necrosis in 2 cases (6.1%). The long-term complications included non-healing wounds in 21 cases (63.6%), serious scar in 28 cases (84.8%), discomfort in 25 cases (75.8%), and dysfunction of the quadriceps femoris in 16 cases (48.5%).
Conclusion: The occurrence of anterolateral thigh flap donor-site complications is related to the anatomical structure of the anterolateral thigh region, the surgical procedure, and the patient's physique.