Abstract
The technique of raising an anterolateral thigh (ALT) perforator flap has been revolutionised by free-style retrograde intramuscular dissection of perforators to overcome anatomical variations, but choosing the appropriate perforator is still the key to success. We have shown this in a 41-year-old man with cancer of the buccal mucosa treated by wide excision and reconstruction with an ALT free flap that failed because of formation of microthrombi within the perforator. We identified only one tiny perforator that followed an 8 cm, tortuous course within the vastus lateralis muscle. A long, narrow lumen in the perforator increases resistance proportionally to the length and four times the radius. Difficult dissection of the root makes the vessels prone to spasm. If no sizeable perforator is found, adjacent tissues on the medial or proximal thigh could be raised as alternative free-style flaps.
| Original language | English |
|---|---|
| Pages (from-to) | 830-832 |
| Number of pages | 3 |
| Journal | British Journal of Oral and Maxillofacial Surgery |
| Volume | 54 |
| Issue number | 7 |
| DOIs | |
| State | Published - 01 09 2016 |
| Externally published | Yes |
Bibliographical note
Publisher Copyright:© 2016
Keywords
- Anterolateral thigh flap
- Free-style free flap
- Perforator
