gms | German Medical Science

Objectives/Interrogation: To explore the feasibility and clinical effect of freestyle concept in the anterolateral thigh flap with oblique branch repairing the soft tissue defect of extremities.

Methods: Twelve patients with soft tissue defects in extremities were repaired using anterolateral thigh flaps with oblique branch from January 2015 to December 2017. The distance of perforator through the muscle was greater than 8.0 cm. The flaps were harvested based on freestyle concept. End-to-side anastomosis or end-to-end anastomosis was performed, posterior tibial artery end-to-side anastomosis in 3 cases, posterior tibial artery branch end-to-end anastomosis in 2 cases, anterior tibial artery end-to-side anastomosis in one case, anterior tibial artery branch end-to-end anastomosis in one case, radial artery end-to-side anastomosis in 3 cases, and radial artery branch end-to-end anastomosis in 2 cases. The flap size ranged from 10 cm × 6 cm to 18 cm x 9cm. The donor sites were closed directly for 9 cases and skin grafting for 3 cases.

Results and Conclusions: 11 cases survived uneventfully, one case suffered from arterial congestion, which was solved by reoperation. All of the patients were followed-up 1 to 12 months, average of 5 months. All flaps showed good texture matches and contour.

When patients are repaired using anterolateral thigh flaps with oblique branch, the distance of perforator through the muscle is longer, the flaps can be harvested based on freestyle concept and end-to-side anastomosis or end-to-end anastomosis can be performed, good clinical effect can also be achieved.