Vascular anatomy of anterolateral thigh flap.

OBJECTIVES

To understand the vascular anatomy of the anterolateral thigh (ALT) free flap. To anatomically determine whether including a 2-cm cuff of vastus lateralis muscle (VLM) incorporates musculocutaneous perforators in the harvest of the ALT free flap.

STUDY DESIGN

Anatomic study on human cadavers.

METHODS

Twenty-seven cadaver thighs were dissected. Musculocutaneous perforators from the vascular pedicle of the ALT free flap were identified. The distance from the anterior border of the VLM to the point where perforators entered the muscle was measured.

RESULTS

An average of four musculocutaneous perforators to the ALT free flap were identified per thigh. The distance from the anterior border of the VLM to the point where perforators entered the muscle ranged from 0.1 to 7 cm, with the mean distance being 1.80 cm. Sixty-four percent of perforators entered the VLM within 2 cm of the muscle's anterior border. At least one perforator entered the VLM within 2 cm of the muscle's anterior border per thigh.

CONCLUSIONS

Most musculocutaneous perforators to the ALT free flap enter the VLM within 2 cm of the muscle's anterior border, thus providing for an anatomic basis for including a 2 cm cuff of VLM when harvesting the ALT free flap. By including a 2 cm cuff of VLM, tedious dissection of individual musculocutaneous perforators is unnecessary, thereby increasing the ease of dissection and expediting the harvest of the ALT free flap.