Lee Min Jae, Yun In Sik, Rah Dong Kyun, Lee Won Jai
Department of Plastic and Reconstructive Surgery, Yonsei University College of Medicine, Seoul, Korea.
Arch Plast Surg. 2012 Jul;39(4):367-75. doi: 10.5999/aps.2012.39.4.367. Epub 2012 Jul 13.
The anterolateral thigh (ALT) perforator flap has become a popular option for treating soft tissue defects of lower extremity reconstruction and can be combined with a segment of the vastus lateralis muscle. We present a comparison of the use of the ALT fasciocutaneous (ALT-FC) and myocutaneous flaps.
We retrospectively reviewed patients in whom free-tissue transfer was performed between 2005 and 2011 for the reconstruction of lower extremity soft-tissue defects. Twenty-four patients were divided into two groups: reconstruction using an ALT-FC flap (12 cases) and reconstruction using a vastus lateralis myocutaneous (VL-MC) flap (12 cases). Postoperative complications, functional results, cosmetic results, and donor-site morbidities were studied.
Complete flap survival was 100% in both groups. A flap complication was noted in one case (marginal dehiscence) of the ALT-FC group, and no complications were noted in the VL-MC group. In both groups, one case of partial skin graft loss occurred at the donor site, and debulking surgeries were needed for two cases. There were no significant differences in the mean scores for either functional or cosmetic outcomes in either group.
The VL-MC flap is able to fill occasional dead space and has comparable survival rates to ALT-FC with minimal donor-site morbidity. Additionally, the VL-MC flap is easily elevated without myocutaneous perforator injury.
股前外侧（ALT）穿支皮瓣已成为治疗下肢重建软组织缺损的常用选择，并且可与一段股外侧肌联合使用。我们对股前外侧筋膜皮瓣（ALT-FC）和肌皮瓣的应用进行了比较。
我们回顾性分析了2005年至2011年间因下肢软组织缺损重建而接受游离组织移植的患者。24例患者分为两组：使用ALT-FC皮瓣重建（12例）和使用股外侧肌肌皮瓣（VL-MC）重建（12例）。研究了术后并发症、功能结果、美容效果和供区并发症。
两组皮瓣完全存活均为100%。ALT-FC组有1例出现皮瓣并发症（边缘裂开），VL-MC组未出现并发症。两组供区均有1例发生部分植皮丢失，2例需要进行减容手术。两组在功能或美容结果的平均评分上均无显著差异。
VL-MC皮瓣能够填补偶尔出现的死腔，与ALT-FC皮瓣的存活率相当，且供区并发症最少。此外，VL-MC皮瓣易于掀起，不会损伤肌皮穿支。
