Objective To investigate the clinical effect of repairing large limbs soft tissue defect by using the lobulated anterolateral thigh perforator flap. Methods F168 cases of the lobulated anterolateral thigh perforator flap was used to repair large soft tissue defect of limbs were collected from November 2014 to April 2024. The area of the flap was 24 cm×7 cm -37 cm×10 cm. The arteriovenous and cutaneous nerves of the perforator flap were anastomosed with those of the recipient area. The patients were followed-up by the way of outpatient service and wechat for 5 months-7 years, including flap survival, color and texture, appearance, sensory recovery, donor site healing. Results 165 cases of flap survived without infection. Necrosis occurred in 1 case of perforator flap and 2 cases of the whole flap. The clean wound through debridement operation was healed with free skin transplantation. There was no osteofascial compartment syndrome after cosmetic suture in the donor area. 3 cases of the skin flap appearance was slightly bloated, after the second stage of the skin flap plastic surgery, the appearance was satisfactory. After operation, the donor area of the flap showed linear scar with concealed location and no obvious hyperplasia. Conclusions The anterolateral femoral perforator flap is nourished by the lateral circumflex femoral artery, which has relatively stable anatomic branches and many perforating branches, and is suitable for the design of lobed flap. The lobular design and incision method can repair multiple wounds in similar locations. In addition, the width of the recipient area can be converted into the length of the donor area, so that the donor area can close the wound in the first stage. At the same time, the anatomical boundary of the hands and feet can show a good physiological fold line through the segmentation design. Lobulated anterolateral thigh perforator flap is an ideal method to repair complex soft tissue defects of limbs.
Key words
Lobulated /
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Perforator flap /
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Lateral circumflex femoral artery /
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Soft tissue defect /
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Limb
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