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Subject Area

Internal Medicine

Article Type

Original Study

Abstract

Objectives To study and evaluate the indications, advantages, disadvantages, and complications of reconstruction of complex soft tissue defects in the lower extremities using free anterolateral thigh (ALT) perforator flap. Background Selection of the best suitable free flap for reconstruction of extensive lower limb soft tissue defects continues to pose a formidable challenge for plastic surgeons. The free ALT perforator flap provides a perfect solution for reconstruction of complex lower limb defects. The present study evaluates the usage of free ALT flap in lower limb reconstruction. Patients and methods Twenty-one patients who had extensive soft tissue defect in the lower extremities and were reconstructed by free ALT flap have been reported in this prospective study from December 2016 to March 2018. All of the patients' data (age, sex, and comorbidities), defects data (etiology, site, and size), microvascular and flap data, postoperative complications, and follow-up data including esthetic and functional outcome were recorded. Results The mean age was 27.7 years. The main cause of soft tissue defects was trauma in 13 patients, and the most common site was dorsum of the foot in seven patients. Overall, 15 fasciocutaneous and 4 myofaciocutaneous free ALT had been done on posterior tibial vessels, mainly in 12 cases. The success rate was 89.6%, with total flap necrosis in 5.4% and partial necrosis in 5.4%. Conclusion The free ALT perforator flap offers a variety of tissues available from a single donor site as an excellent option for reconstruction of large and extensive soft tissue defects in the lower extremities.

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