• Archives of Reconstructive Microsurgery
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• v.16 no.1
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• pp.39-47
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• 2007

With the advent of microsurgery, perforator free flap is nowadays considered the first choice for reconstruction of the extensive defect of the extremities because of their moderate thickness. Among them, anterior (anterolateral and anteromedial) thigh perforator free flaps provide the first choice for reconstruction of various soft tissue defects of the extremities with many advantage such as its large, uniform thickness, long vascular pedicle with proper vessel size and minimal donor site morbidity. But, it has still some criticism of unreliable perforators which makes us very careful in elevating the flap. Between March of 2006 and February of 2007, we treated 7 patients of soft tissue defects in the hand and lower extremities with anterior thigh perforator free flap at Hallym and DongGuk University Hospital. We performed 6 anterolateral thigh perforator free flaps based on the descending branch of lateral circumflex femoral artery (LCFA) and 1 anteromedial thigh perforator free flap based on the innominate branch of the LCFA. While approaching for the anterolateral thigh free flap, we happen to meet the cases which we should change into the anteromedial thigh free flap uneventfully on the operating field. In contrast to the original design of anterolateral thigh free flap, we had to harvest the anteromedial thigh perforator free flap in 1 case. All the anterior thigh perforator free flaps survived completely except 1 case of partial necrosis due to venous congestion. Donor sites were closed primarily and healed uneventfully within 2 weeks. Patients were satisfied with the functionally and aesthetically acceptable results. Although doppler sonography is strongly recommended preoperatively in planning the anterior thigh perforator free flaps, we should always remember the variation in vascular anatomy and be ready to change the flap choice from the anterolateral to anteromedial intraoperatively. we provide a review of the literature and present our series of anterior thigh perforator free flaps for reconstruction of the extremities.

• Journal of Korean Foot and Ankle Society
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• v.11 no.2
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• pp.232-237
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• 2007

Introduction: To report the result of the thigh perforator free flap for the reconstruction of the soft tissue defect of the lower extremities and usefulness of this flap. Materials and Methods: We have performed 23 cases of thigh perforator free flap to reconstruct the soft tissue defect of the lower extremities between February 2004 and July 2005. The anterior aspect of the legs were 9 cases, the ankle joints were 4 cases, the dorsal aspect of the feet were 6 cases, the sole of the feet were 4 cases as recipient sites. The anterolateral thighs were 13 cases, the anteromedial thighs were 10 cases as donor sites. The size of the flap ranged from $4{\times}5\;cm$ to $12{\times}18\;cm$. The mean flap area was $73.2\;cm^2$. The length of the pedicle ranged from 5 cm to 15 cm. Every patient except children was operated under the spinal anesthesia. Results: 21 flaps (91.3%) survived, 2 flaps (8.7%) failed. In the 21 flaps that had survived, there were partial necrosis in 4 cases, which healed without any additional operation. In the 13 anterolateral thigh perforator flaps, 9 cases survived totally, 3 cases had the partial necrosis, 1 case failed. In the 10 anteromedial thigh perforator flaps, 8 cases survived totally, 1 case had the partial necrosis, 1 case failed. Conclusion: The authors had a good result with the thigh perforator free flap and believe that this flap is a good option for the reconstruction of the soft tissue defect of the lower extremities, because this flap has a thin thickness and it is easy to dissect the vessels. Moreover the patients can be operated with supine position.