Objective: To investigate the anatomic variations of the perforator vessels of anterolateral thigh (ALT) flap and the clinical indications.
Methods: From March 1985 to August 2004, the anterolateral thigh flap graft was performed in 112 patients. The clinical data were analyzed. There were 67 males and 45 females, aging from 5 to 65 years with an average of 38. 5 years. According to recipient site condition, four methods of flap harvesting were as follows: (1) 78 received free fasciocutaneous flaps; (2) 22 received free adipofascial flaps; (3) 5 received pedicled island fasciocutaneous flaps; (4) 7 received pedicled reverse-flow island fasciocutaneous flaps. Facial, neck, breast, extremity joint, plantar, and perineum defects were repaired and the effectiveness and donor site morbidity were evaluated.
Results: The blood supply of ALT flap came from the descending branch or transverse branch of the lateral circumflex femoral artery. The skin vessels were found to be septocutaneous perforators in 33% of flaps and to be musculocutaneous perforators in 77% of flaps. Of 112 flaps, 107 survived completely, the survival rate was 95.6% with little donor site morbidity.
Conclusion: ALT flap is a versatile soft-tissue flap. If refined to perforator flap, it can achieve better results in reconstructing defect and minimizing donor-site morbidity.