gms | German Medical Science

Objectives/Interrogation: The anterolateral thigh flap is becoming the flap of choice for reconstruction of soft tissue defect with primary donor-site closure. The purpose of this report was to review the reconstruction of dorsal and palm defects of hand by the anterolateral thigh flaps from one donor site.

Methods: From 2016 to 2017, eight patients with dorsal and palm defects of hand were reconstructed with the anterolateral thigh flaps from the one donor site. At least two separate cutaneous perforator vessels are identified on Doppler before the operation and dissected in a retrograde fashion back to the descending branch of the lateral circumflex femoral artery. The skin paddle is then divided between the two cutaneous perforators to give two separate paddles. The cutaneous perforators of the two paddles were from a common vascular supply in seven cases. One cutaneous perforator was anastmosed to the branch of the other cutaneous perforator of the paddle to make a common vascular supply in one case.

Results and Conclusions: All flaps survived completely. There were 16 flaps. The area of the flap was from 18cm×8cm to 7cm×4cm. Arterial crisis occurred in one case and finally the flaps survived after another surgery. The flap was bulky in 2 cases. The contracture of first web and flap bulky both occurred in three cases. These five cases were satisfactory with the functional and appearance results after another surgery. The sensation of the flaps was S2. All of the donor sites healed well in one stage.

It is a good method to use the anterolateral thigh flaps from one donor site to repair the dorsal and palm defects of hand with minimal donor site morbidity.