Abstract: Objective　To provide reference for anterolateral thigh flap (ALTF ) design by using handheld Doppler ultrasound to observe the surface position and number of the ALTF perforating vessels.　Methods　Before the operation, line α was the connection between the anterior superior iliac spine and the upper superior patella. Line β was the connection between the point  A and the pulsation point (B) of the pulse point of femoral artery under  inguinal ligament,    which was the surface projection of the descending branch of the lateral femoral circumflex artery. The handheld Doppler ultrasound was used to find the perforating branches in the circular area with the radius of 3 cm centered on the point A, and the anterior anterolateral thigh flaps were designed with the most obvious perforator pulsation. There was 8 cases of clinical applying in our department from Apr. 2016 to Sep. 2019, all of which were soft tissue defects of lower limbs, the largest flap size was 21cm × 10cm, the smallest 8 cm×6 cm.　Results　Most of the anterolateral thigh flaps were located around point A, and the thick perforators were located outside the point A. For 8 cases of flaps, 7 cases all survived, 1 case had partial epidermal necrosis at the distal end of the flap,  and which healed after dressing change. After 5~12 months of outpatient follow-up, the flap survived well, the shape and function were good.　Conclusions　Preoperative application of handheld Doppler ultrasound can effectively locate the reliable perforating branch of the anterolateral thigh flap, thereby improving the accuracy and safety of flap removal and reducing the operation time.

Key words:  , Lateral femoral artery descending branch, 　Perforator flap, 　Wound repair, 　Soft tissue defect