Langer S, Steinsträsser L, Lehnhardt M, Strack N, Steinau H U, Daigeler A, Homann H H
Klinik für Plastische Chirurgie und Schwerbrandverletzte, Handchirurgiezentrum, Operatives Referenzzentrum für Extremitätentumore, Berufsgenossenschaftliches Universitätsklinikum Bergmannsheil, Bochum, Germany.
Unfallchirurg. 2008 May;111(5):323-30. doi: 10.1007/s00113-007-1355-y.
The anterolateral thigh flap (ALT) has become one of the most preferred options for soft tissue defect reconstruction in Asia with an increasing popularity in Europe. The article presents the authors' experience using the ALT flap for various indications in the upper and lower extremities.
Between January 2005 and March 2007, 60 free ALT flaps were operated for reconstruction of various soft tissue defects. The causes of soft tissue defects included trauma (13), infection (26), and sarcoma resection (21). We operated on 39 male and 19 female patients with an average age of 50.9 years (range: 16-84 years).
The flap survival rate was 95.0% percent (57 of 60 flaps); 5% of the flaps died. The donor site was closed primarily in all cases. Donor site complications were minimal. The average operative time was 282 min (69-544 min). Flap-related major complications occurred in 35.0% of patients including reexploration of the anastomoses and partial flap necrosis. Minor complications, e.g., wound infection, hematoma, and swelling were seen in 23 cases.
Our experience indicates that the free ALT flap is a reliable method for soft tissue defect reconstruction. The use of the ALT offers many advantages such as a long and large caliber vascular pedicle, a large skin island as well as minimal donor site morbidity. The surgery can simultaneously performed by two teams with the patient in a supine position.
股前外侧皮瓣（ALT）已成为亚洲软组织缺损重建最常用的选择之一，在欧洲也越来越受欢迎。本文介绍了作者使用ALT皮瓣治疗上下肢各种病症的经验。
2005年1月至2007年3月期间，60例游离ALT皮瓣用于重建各种软组织缺损。软组织缺损的原因包括创伤（13例）、感染（26例）和肉瘤切除（21例）。我们对39例男性和19例女性患者进行了手术，平均年龄为50.9岁（范围：16 - 84岁）。
皮瓣存活率为95.0%（60例皮瓣中的57例）；5%的皮瓣坏死。所有病例供区均一期缝合。供区并发症极少。平均手术时间为282分钟（69 - 544分钟）。35.0%的患者发生了与皮瓣相关的主要并发症，包括吻合口再次探查和部分皮瓣坏死。23例出现了轻微并发症，如伤口感染、血肿和肿胀。
我们的经验表明，游离ALT皮瓣是软组织缺损重建的可靠方法。使用ALT皮瓣有许多优点，如血管蒂长且管径大、皮岛大以及供区并发症少。手术可由两个团队同时进行，患者取仰卧位。
