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CC BY-NC 4.0 · Arch Plast Surg 2013; 40(02): 91-96
DOI: 10.5999/aps.2013.40.2.91
Review Article

Adipofascial Anterolateral Thigh Flap Safety: Applications and Complications

Tommaso Agostini
Maxillofacial Surgery Unit, Hospital of Florence, Florence, Italy
,
Giulia Lo Russo
Plastic Surgery Unit, University Hospital of Florence, Florence, Italy
,
Yi Xin Zhang
Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
,
Giuseppe Spinelli
Maxillofacial Surgery Unit, Hospital of Florence, Florence, Italy
,
Davide Lazzeri
Plastic and Reconstructive Surgery Unit, Hospital of Pisa, Pisa, Italy
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Background A thinned anterolateral thigh (ALT) flap is often harvested to achieve optimal skin resurfacing. Several techniques have been described to thin an ALT flap including an adipocutaneous flap, an adipofascial flap and delayed debulking.

Methods By systematically reviewing all of the available literature in English and French, the present manuscript attempts to identify the common surgical indications, complications and donor site morbidity of the adipofascial variant of the ALT flap. The studies were identified by performing a systematic search on Medline, Ovid, EMBASE, the Cochrane Database of Systematic Reviews, Current Contents, PubMed, Google, and Google Scholar.

Results The study selection process was adapted from the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement, and 15 articles were identified using the study inclusion criteria. These articles were then reviewed for author name(s), year of publication, flap dimensions and thickness following defatting, perforator type, type of transfer, complications, thinning technique, number of cases with a particular area of application and donor site morbidity.

Conclusions The adipofascial variant of the ALT flap provides tissue to fill large defects and improve pliability. Its strong and safe blood supply permits adequate immediate or delayed debulking without vascular complications. The presence of the deep fascia makes it possible to prevent sagging by suspending and fixing the flap for functional reconstructive purposes (e.g., the intraoral cavity). Donor site morbidity is minimal, and thigh deformities can be reduced through immediate direct closure or liposuction and direct closure. A safe blood supply was confirmed by the rate of secondary flap debulking.

Keywords

Free flaps - Microsurgery - Systematic review


Publication History

Received: 21 September 2012

Accepted: 24 December 2012

Article published online:
01 May 2022

© 2013. The Korean Society of Plastic and Reconstructive Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonCommercial License, permitting unrestricted noncommercial use, distribution, and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes. (https://creativecommons.org/licenses/by-nc/4.0/)

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