Pedrazzi Nadine E, Schweizer Riccardo, Klein Holger J, Steiner Stephan, Vonlanthen René, Hermanns Thomas, Schneiter Didier, Giovanoli Pietro, Plock Jan A
From the Department of Plastic Surgery and Hand Surgery, Cantonal Hospital Aarau, Aarau, Switzerland.
Department of Plastic Surgery and Aesthetic Surgery, Lugano Regional Hospital, Lugano, Switzerland.
Plast Reconstr Surg Glob Open. 2025 Jan 13;13(1):e6433. doi: 10.1097/GOX.0000000000006433. eCollection 2025 Jan.
Abdominal wall reconstruction represents an ambitious and demanding challenge. This study aimed to illustrate the versatility of the anterolateral thigh (ALT) flap in its different designs for the reconstruction of complex defects of the abdominal wall.
Charts of patients with complex abdominal wall defects who underwent a reconstruction with an ALT flap at the University Hospital of Zurich (2018-2020) were reviewed retrospectively. Patient characteristics and ALT flaps used were analyzed in detail.
Ten patients received a total of 12 ALT flaps. Free flaps were applied to defects in the upper third of the abdomen. All flaps were harvested with a fascial component. An iliotibial tract reinforcement was incorporated in 4 (33%) cases, and 1 case included a muscular component and motor nerve, to provide functional reconstructive potential. A total of 30% of cases experienced complications requiring surgical revision during a mean follow-up of 5 months.
The ALT flap represents a workhorse in abdominal wall reconstruction due to its versatility and anatomical proximity. Depending on the localization of the defect, this flap can be used in a pedicled or free microsurgical manner. The fascial component of the ALT fasciocutaneous flap and of the extended iliotibial tract provides stable fascia for reinforcement or fascial reconstruction of the abdominal wall. Raised as a chimeric flap with vastus lateralis muscle and motor branch of the femoral nerve, it is a viable option for functional reconstructions.
腹壁重建是一项艰巨且具有挑战性的任务。本研究旨在阐述股前外侧（ALT）皮瓣在不同设计下用于重建复杂腹壁缺损的多功能性。
回顾性分析2018年至2020年在苏黎世大学医院接受ALT皮瓣重建的复杂腹壁缺损患者的病历。详细分析患者特征及所使用的ALT皮瓣。
10例患者共接受了12个ALT皮瓣。游离皮瓣用于上腹部三分之一处的缺损。所有皮瓣均带有筋膜成分进行切取。4例（33%）采用了髂胫束加强，1例包含肌肉成分及运动神经，以提供功能重建潜力。在平均5个月的随访期间，共30%的病例出现需要手术修正的并发症。
ALT皮瓣因其多功能性及解剖位置临近，在腹壁重建中堪称主力。根据缺损部位，该皮瓣可采用带蒂或游离显微外科方式使用。ALT筋膜皮瓣及扩展髂胫束的筋膜成分可为腹壁加强或筋膜重建提供稳定的筋膜。作为带有股外侧肌和股神经运动支的嵌合皮瓣切取时，它是功能重建的可行选择。
