Comparison of pedicled and free anterolateral thigh flaps for reconstruction of complex defects of the abdominal wall: Review of 20 consecutive cases

Shuji Kayano, Minoru Sakuraba, Shimpei Miyamoto, Shogo Nagamatsu, Megumi Taji, Hiroki Umezawa, Yoshihiro Kimata

Research output: Contribution to journalArticle

31 Citations (Scopus)

Abstract

Background: The reconstruction of large, complex defects of the abdominal wall after the ablation of malignant tumours can be challenging. The transfer of an anterolateral thigh (ALT) flap is an attractive option. This study compared free ALT flaps and pedicled ALT flaps for abdominal wall reconstruction. Methods: From 1996 through 2011, 20 patients underwent abdominal wall reconstruction with ALT flaps. The flaps were pedicled in 12 patients and free in eight patients. Medical records were reviewed for complications and clinical and demographic data. Abdominal wall defects were classified into the following four groups: upper midline, lower midline, upper quadrants and lower quadrants. Results: Pedicled flaps were transferred to the upper midline region in one patient, the lower midline region in six patients and lower quadrants in five patients. Free flaps were transferred to the lower midline region in two patients, upper quadrants in four patients and lower quadrants in two patients. Mean reconstructive time was significantly longer with free flaps (6 h 32 min) than with pedicled flaps (4 h 55 min, p = 0.035). Although free flaps (mean size, 360 cm2) were larger than pedicled flaps (mean size, 289 cm2), the difference was not significant (p = 0.218). The rates of complications did not differ between free flaps and pedicled flaps. No total flap loss occurred, and there was partial loss of only a single pedicled flap, which was the flap furthest from the pivot point. Infections developed of two pedicled flaps and three free flaps. Conclusion: This study suggests that complication rates do not differ between free and pedicled ALT flaps. The choice of flap depends on the size and location of the defect and the length of the vascular pedicle.

Original languageEnglish
Pages (from-to)1525-1529
Number of pages5
JournalJournal of Plastic, Reconstructive and Aesthetic Surgery
Volume65
Issue number11
DOIs
Publication statusPublished - Nov 2012

Keywords

  • Abdominal
  • Anterolateral
  • Flap
  • Thigh
  • Wall

ASJC Scopus subject areas

  • Surgery

Fingerprint Dive into the research topics of 'Comparison of pedicled and free anterolateral thigh flaps for reconstruction of complex defects of the abdominal wall: Review of 20 consecutive cases'. Together they form a unique fingerprint.

  • Cite this