J Reconstr Microsurg 2006; 22 - A030
DOI: 10.1055/s-2006-955150

Using the Descending Branch of the Lateral Femoral Circumflex Vessel as a Source of Two Independent Flaps

Erh-Kang Chou 1, B. Ulusal 1, A. Ulusal 1, F.C. Wei 1, C.H. Lin 1, C.K. Tsao 1
  • 1Chang Gung Memorial Hospital, Tapei, Taiwan

Simultaneous reconstruction of two separate defects by two free flaps is time-consuming and often requires two donor sites. The anterior and lateral aspect of the thigh is an ideal donor site for free tissue harvest without incurring significant morbidity. The authors described their technique of harvesting two independent fasciocutaneous free flaps from the same descending branch of the lateral circumflex femoral vessels as a new clinical application of the versatile anterolateral thigh flap.

A total of eight flaps were developed from the left thighs of four patients. There were two males and two females with a mean age of 42.0 years. The defects were either on the lower extremity (n = 2) or in the oral cavity (n = 2). Each anterolateral aspect of the thigh was used to develop two perforator flaps, based on one perforator each. The anterolateral thigh flap was elevated in the standard manner based on at least two cutaneous vessels of the descending branch of the lateral circumflex femoral artery. The skin flaps were tailored to the recipient site requirements, and the main descending branches of the lateral femoral circumflex vessels were divided between to be used as the pedicle of both flaps. The mean flap dimensions ranged from 2.5 × 4 cm to 8 × 12 cm (mean: 5 × 8 cm). The mean operative time was 11 hr 30 min. The mean length of the pedicle was 9 cm (range: 8 to 11 cm). The mean external diameter of the descending branch in the mid thigh and where it joined to the LFCA was 1.75 mm and 3 mm, respectively. Three donor sites were directly closed, and one grafted.

All flaps survived completely and no complications were encountered. Donor-site morbidity was negligible. Hospitalization averaged 9.9 ± 1.7 days.

Two fasciocutaneous flaps based on independent skin vessels can be reliably harvested from the same descending branch of the lateral femoral circumflex artery for simultaneous reconstruction of two separate defects.