Free Anterolateral Thigh flap for traumatic soft tissue defects of distal third leg and foot Comparative study between Subfascial and Suprafascial dissection

Fahmy, Mohamed; El Habaa, Gamal; Ayad, Wael; Elgohary, Hussein; Abdelmofeed, Ayman

doi:10.21608/bmfj.2021.18550.1124

Free Anterolateral Thigh flap for traumatic soft tissue defects of distal third leg and foot Comparative study between Subfascial and Suprafascial dissection

Document Type : Original Article

Authors

¹ General Surgery department, faculty of medicine, Benha University, Egypt

² General surgery department, faculty of medicine, benha university, Egypt

³ plastic surgery department, faculty of medicine, alazhar university, Egypt

⁴ General surgey department, faculty of medicine, benha university, Egypt

10.21608/bmfj.2021.18550.1124

Abstract

ABSTRACT
Background
Lower extremity injuries requiring soft tissue coverage comprises a significant proportion of these injuries. The advantage of free tissue transfer has provided multiple options for complex defects of the lower extremities that maintain the functional and aesthetic status of the limb. Since the first report of the ALT flap in 1984, it has become one of the most commonly used flaps for the reconstruction of various soft tissue defects because it has long vascular pedicle, suitable vessel diameter with acceptable donor site morbidity.
Participants and Methods
A prospective study was carried out on 25 patients with clinical diagnosis of complex soft tissue defects in distal third leg and foot; Patients were divided into two groups who underwent Fasciocutaneous and Cutaneous ALT, to compare between both groups in many aspects including complication rates, aesthetic and functional outcomes of donor and recipient sites.
Results
As regard recipient site complications including congestion and partial flap necrosis were higher in group I. There were significant differences between both groups as regard donor site functional outcome including sensory disturbance and cold intolerance were higher in group I. Flap bulkiness was significantly higher in group I.
Conclusion
In our experience, we found that the ALT free flap offers an excellent option for reconstruction of complex soft tissue defects in the lower extremities with perfect functional and aesthetic results that achieved through elevating Cutaneous ALT flap to avoid sensory disturbance of the donor site and secondary surgical debulking after Fasciocutaneous ALT flap.

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