Agostini Tommaso, Russo Giulia Lo, Zhang Yi Xin, Spinelli Giuseppe, Lazzeri Davide
Maxillofacial Surgery Unit, Hospital of Florence, Florence, Italy.
Arch Plast Surg. 2013 Mar;40(2):91-6. doi: 10.5999/aps.2013.40.2.91. Epub 2013 Mar 11.
A thinned anterolateral thigh (ALT) flap is often harvested to achieve optimal skin resurfacing. Several techniques have been described to thin an ALT flap including an adipocutaneous flap, an adipofascial flap and delayed debulking.
By systematically reviewing all of the available literature in English and French, the present manuscript attempts to identify the common surgical indications, complications and donor site morbidity of the adipofascial variant of the ALT flap. The studies were identified by performing a systematic search on Medline, Ovid, EMBASE, the Cochrane Database of Systematic Reviews, Current Contents, PubMed, Google, and Google Scholar.
The study selection process was adapted from the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement, and 15 articles were identified using the study inclusion criteria. These articles were then reviewed for author name(s), year of publication, flap dimensions and thickness following defatting, perforator type, type of transfer, complications, thinning technique, number of cases with a particular area of application and donor site morbidity.
The adipofascial variant of the ALT flap provides tissue to fill large defects and improve pliability. Its strong and safe blood supply permits adequate immediate or delayed debulking without vascular complications. The presence of the deep fascia makes it possible to prevent sagging by suspending and fixing the flap for functional reconstructive purposes (e.g., the intraoral cavity). Donor site morbidity is minimal, and thigh deformities can be reduced through immediate direct closure or liposuction and direct closure. A safe blood supply was confirmed by the rate of secondary flap debulking.
通常采用变薄的股前外侧（ALT）皮瓣来实现最佳的皮肤重建。已经描述了几种使ALT皮瓣变薄的技术，包括脂肪皮下组织皮瓣、脂肪筋膜皮瓣和延迟减容。
通过系统回顾所有可用的英文和法文文献，本手稿试图确定ALT皮瓣脂肪筋膜变体的常见手术适应证、并发症和供区并发症。通过对Medline、Ovid、EMBASE、Cochrane系统评价数据库、现刊目次、PubMed、谷歌和谷歌学术进行系统检索来识别这些研究。
研究选择过程采用系统评价和Meta分析的首选报告项目声明，使用研究纳入标准识别出15篇文章。然后对这些文章进行审查，内容包括作者姓名、发表年份、去脂后的皮瓣尺寸和厚度、穿支类型、转移类型、并发症、变薄技术、特定应用区域的病例数以及供区并发症。
ALT皮瓣的脂肪筋膜变体可提供组织以填充大的缺损并改善柔韧性。其强大而安全的血供允许进行充分的即刻或延迟减容而无血管并发症。深筋膜的存在使得通过悬吊和固定皮瓣以达到功能重建目的（如口腔内）来防止下垂成为可能。供区并发症极少，通过即刻直接缝合或吸脂后直接缝合可减少大腿畸形。二次皮瓣减容率证实了血供安全。
