Usefulness in combined free anterolateral thigh and vastus lateralis muscle flaps

Background

The anterolateral thigh flap has been a popular flap in reconstructive surgery. However, the details concerning the anterolateral thigh flap combined with the vastus lateralis muscle flap have not been reported. We described the surgical procedures, complication of the donor site, and advantages and disadvantages of this combined flap.

Methods

We analyzed 29 patients who underwent reconstruction with an anterolateral thigh flap–vastus lateralis muscle flap.

Results

The recipient sites were in the head and neck area (n?=?25), extremities (n?=?3), and trunk (n?=?1). The vastus lateralis was used as a muscle flap in 28 cases. The rectus femoris was harvested in one case because the vastus lateralis could not be harvested with a skin flap. Four cases required two vastus lateralis muscle flaps with a skin flap. Partial ischemia of the muscle flap occurred in one case. Additional donor-site surgery was required in two cases. No donor-site dysfunction was observed in our series.

Conclusion

This combined flap is advantageous in that the volume and number of muscle flaps can be adjusted and the skin and muscle flaps can be placed in separate positions. Although harvesting this flap is safe and not difficult, attention should be paid to anatomical variations of the vascular pedicle supplying the skin and muscle flap and to the circulation of the muscle flap. Level of Evidence: level IV, therapeutic study.