Abstract
This paper presents the scheme to select alternative flaps limited to the region of
the ipsilateral thigh when the perforator of the anterolateral thigh flap is not feasible.
Total of 564 consecutive microsurgery cases using anterolateral thigh perforator flap
was reviewed from March of 2001 to January of 2009. Total of 12 cases used a contingent
flap due to anatomical and technical complications of the anterolateral thigh perforator.
The alternatives were skin perforator flaps adjacent to the initial flap (3 cases
of upper anterolateral thigh flap, 4 cases of anteromedial thigh flap), vastus lateralis
muscle flap with skin graft (2 cases), and anterolateral thigh flap as septocutaneous
flap without a prominent perforator on the septum (3 cases). All flaps survived and
provided coverage as planned but one case using septocutaneous flap without a prominent
perforator was noted with partial necrosis. Adjacent flaps around the anterolateral
thigh perforator flap may provide useful alternative flaps in cases of failed elevation.
Limiting the contingent secondary flap to this region may reduce further donor site
morbidity and still provide an adequate flap for reconstruction.
Keywords
Alternative to anterolatral thigh perforator flap - Perforator flap
