Reconstruction of multiple long digital and hand defects using the multilobed anterolateral thigh perforator flap.

OBJECTIVE: This study investigated the reconstruction of multiple long digital and hand defects using the multilobed anterolateral thigh perforator flap. METHODS: From January 2018 to January 2021, 14 patients (hands) with multiple long digital defects were treated using the multilobed anterolateral thigh perforator flap. The mean age of the patients was 35 years (range, 18-55 years). The mean size (length × width) of the defects was 12.3 × 10.6 cm (range, 9 × 7 cm-16 × 12 cm). The mean size of the flap was 13.7 × 12.1 cm (range, 11 × 8 cm-19 × 14 cm). The total active motion was compared to the opposite side (100% normal, excellent; 75%-99% normal, good; 50%-74% normal, fair; <50% normal, poor). RESULTS: In this series, 12 flaps survived completely. Partial flap necrosis occurred in 2 patients but healed with wound care. The mean follow-up period was 28 months (range, 25-34 months). Based on the total active motion scoring system, we got 1 excellent, 7 good, 7 fair, and 1 poor result. A second surgery to separate the digits was not required. CONCLUSION: Multiple digital and hand defects can be reconstructed simultaneously using the multilobed anterolateral thigh perforator flap, allowing a length-to-width ratio of greater than 1.5:1 to resurface long digital defects. LEVEL OF EVIDENCE: Level IV, Therapeutic Study.

Reconstruction of Giant Defects Due to Electrical and Radiation Burns in the Lower Leg with Free Anterolateral Thigh Flaps.

The purpose of this study was to introduce reconstruction of giant soft tissue defects of the lower leg caused by high-voltage electrical burns and radiation burns using the free anterolateral thigh (ALT) flap. From March 2017 to January 2018, 6 patients who sustained high-voltage electrical burns and 2 patients who sustained ulcerated radiation burns were reconstructed using the free ALT flap. The mean size of the defects was 19 cm × 32 cm (range, 18 cm × 22 cm to 30 cm × 36 cm). The mean size of the flaps was 22 cm × 34 cm (range, 20 cm × 24 cm to 32 cm × 38 cm). All flaps survived completely. The mean preoperative Functional Analysis Technique Evaluation score was 62 (range, 43 to 74). The mean follow-up period was 16 months (range, 12 to 18 months). At the final follow-up, the mean postoperative score was 90 (range, 86 to 94). The mean improvement was 33% (range, 17% to 54%) with 4 excellent and 4 good results. For extensive, high-voltage electrical, and radiation burns encompassing the lower leg, early treating the giant soft tissue defects with a free ALT flap produces good functional outcomes without significant complications.