Sadaniantz Katherine, Daly Lauren, Qin Jing Bai, Tracy Jeremiah
University of Massachusetts, Department of Internal Medicine, Worcester, MA, United States of America.
University of Massachusetts, Department of Otolaryngology, Worcester, MA, United States of America.
Am J Otolaryngol. 2022 Jan-Feb;43(1):103238. doi: 10.1016/j.amjoto.2021.103238. Epub 2021 Sep 22.
The free anterolateral thigh (ALT) flap is a versatile reconstructive option for head and neck defects. Donor site complications are rare but severe; with wound dehiscence, need for secondary closure, and compartment syndrome reported.
We propose prophylactic thigh fasciotomy as a surgical technique to facilitate primary closure while preventing donor site complications during ALT flap harvest.
We examined donor site wound characteristics, recipient site wound characteristics, and clinical outcomes for 24 consecutive ALT flaps performed for head and neck reconstruction from 2016 to 2018. All ALT donor sites underwent prophylactic fasciotomy.
There were no incidents of thigh compartment syndrome or wound dehiscence of donor site; one patient underwent primary donor site skin grafting.
Prophylactic thigh fasciotomy allows mobilization of soft tissue to facilitate primary tension-free closure of the ALT donor site even for free flaps with a large skin component, while reducing the possibility of compartment syndrome.
游离股前外侧（ALT）皮瓣是修复头颈部缺损的一种多功能重建选择。供区并发症罕见但严重，有伤口裂开、需要二期缝合以及报道发生骨筋膜室综合征的情况。
我们提出预防性大腿筋膜切开术作为一种手术技术，以便在ALT皮瓣切取过程中促进一期缝合，同时预防供区并发症。
我们检查了2016年至2018年连续进行的24例用于头颈部重建的ALT皮瓣的供区伤口特征、受区伤口特征和临床结果。所有ALT供区均接受了预防性筋膜切开术。
未发生大腿骨筋膜室综合征或供区伤口裂开；1例患者接受了供区一期植皮。
预防性大腿筋膜切开术可使软组织易于移动，以便即使对于带有大面积皮肤成分的游离皮瓣也能对ALT供区进行一期无张力缝合，同时降低骨筋膜室综合征的可能性。
