Summary
Background
The reconstruction of large, complex defects of the abdominal wall after the ablation
of malignant tumours can be challenging. The transfer of an anterolateral thigh (ALT)
flap is an attractive option. This study compared free ALT flaps and pedicled ALT
flaps for abdominal wall reconstruction.
Methods
From 1996 through 2011, 20 patients underwent abdominal wall reconstruction with ALT
flaps. The flaps were pedicled in 12 patients and free in eight patients. Medical
records were reviewed for complications and clinical and demographic data. Abdominal
wall defects were classified into the following four groups: upper midline, lower
midline, upper quadrants and lower quadrants.
Results
Pedicled flaps were transferred to the upper midline region in one patient, the lower
midline region in six patients and lower quadrants in five patients. Free flaps were
transferred to the lower midline region in two patients, upper quadrants in four patients
and lower quadrants in two patients. Mean reconstructive time was significantly longer
with free flaps (6 h 32 min) than with pedicled flaps (4 h 55 min, p = 0.035). Although free flaps (mean size, 360 cm2) were larger than pedicled flaps (mean size, 289 cm2), the difference was not significant (p = 0.218). The rates of complications did not differ between free flaps and pedicled
flaps. No total flap loss occurred, and there was partial loss of only a single pedicled
flap, which was the flap furthest from the pivot point. Infections developed of two
pedicled flaps and three free flaps.
Conclusion
This study suggests that complication rates do not differ between free and pedicled
ALT flaps. The choice of flap depends on the size and location of the defect and the
length of the vascular pedicle.
Keywords
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Article info
Publication history
Published online: May 30, 2012
Accepted:
May 3,
2012
Received:
February 17,
2012
Identification
Copyright
© 2012 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Inc. All rights reserved.
