Application of double foliated anterolateral thigh flap with a single perforator in reconstruction of the skin and soft tissue defects of forearm and hand

Abstract

Objective \nTo evaluate the surgical technique and the clinical effect of the reconstruction of forearm and hand defects, using double foliated anterolateral thigh flap with a single perforator. \n \n \nMethods \nFrom January 2013 to September 2017, 9 cases (forearm, n=3; hand, n=6) of the skin and soft tissue defects were reconstructed with double foliated anterolateral thigh flaps. The patients include 7 males and 2 females, with the mean age of 35.2 years(18-65 years). Blood supply of the double foliated flap was derived from the first musculocutaneous branches of the lateral femoral circumflex artery. The length and width of flaps were adjusted, to close the donor site directly. The descending branch of the lateral circumflex femoral artery was connected to the recipient vessels with end-to-end anastomosis. All cases were followed for the evaluation of appearance, texture, function and donor site condition. \n \n \nResults \nAll flaps survived, and all cases were followed for 3 to 24 months (average 10.5 months). All flaps showed no blood circulation disorder. Except for 4 cases had slightly bloated flap, the other flaps had fine appearance and texture. The donor site left only a linear scar, and the donor thigh had no functional deficiency. \n \n \nConclusions \nDouble foliated anterolateral thigh flap for repairing the large area of the skin and soft tissue defect in hand and forearm could simplify the operation, shorten operation time and reduce operation trauma. It is an ideal method to repair the skin and soft tissue defect of forearm and hand. \n \n \nKey words: \nAnterolateral thigh flap;\xa0Forearm;\xa0Hand;\xa0KISS technique