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J Hand Microsurg 2019; 11(01): 054-056
DOI: 10.1055/s-0038-1672336
Point of Technique
Thieme Medical and Scientific Publishers Private Ltd.

Five Simple Techniques to Enable Rapid Elevation and Donor Site Closure of the Anterolateral Thigh Flap

Dariush Nikkhah
1   Plastic Surgery Department, Queen Victoria Hospital, East Grinstead, United Kingdom
,
Robert Miller
2   Plastic Surgery Department, Royal London Hospital, London, United Kingdom
,
Georgios Pafitanis
2   Plastic Surgery Department, Royal London Hospital, London, United Kingdom
,
Roshan Vijayan
3   Plastic Surgery Department, Royal Free Hospital, London, United Kingdom
,
Parviz Sadigh
2   Plastic Surgery Department, Royal London Hospital, London, United Kingdom
› Author Affiliations Funding None.
Further Information

Publication History

Received: 22 April 2018

Accepted after revision: 10 August 2018

Publication Date:
18 October 2018 (online)

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Abstract

We describe five technical notes to facilitate rapid elevation of the anterolateral thigh flap for extremity reconstruction. We highlight the advantages of (1) a lateral approach; (2) identification of the perforator with the shortest intramuscular distance; (3) deroofing technique with cutting monopolar for pedicle dissection; (4) taking a cuff of vastus lateralis in some cases to avoid unnecessary long perforator dissection; and (5) closure of large donor sites with a modified keystone flap. Using the sequence reduces flap-raising times to 60 to 90 minutes and improves theater usage while achieving excellent outcomes.

Keywords

anterolateral thigh flap - microsurgery - free flap elevation - technical point
 

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