ABSTRACT
Objective: Theobjective of this study was to determine the indications, utility, advantages
and surgical approach for the anteromedial thigh (AMT) flap. Materials and Methods: We reviewed the records of the patients in whom the AMT flap was used for head and
neck reconstruction. We use an anterior approach to harvest the anterolateral thigh
(ALT) flap with a non-committal straight line incision. This preserves both ALT and
AMT flap territories intact, and further decision is based on the intraoperative anatomy
of perforator and pedicle. The ALT flap was usually used as the first choice when
available and suitable. Results: Free AMT skin flaps were harvested in 24 patients. All flaps were used for the head
and neck reconstruction. Two flaps had marginal flap necrosis. One flap was lost due
to venous thrombosis. Discussion: The thigh is an excellent donor site as it has large available skin territory, expendable
lateral circumflex femoral artery system and low donorsite morbidity. The ALT flap
is the most commonly used flap for reconstruction of soft-tissue defects. However,
it is characterised by variable vascular pedicle and perforator anatomy. The AMT flap
is an excellent alternative when the ALT flap is not available due to variable perforator
anatomy, injury to perforator, when an intermediate thickness is needed between distal
and proximal thigh or a chimeric flap is needed. Conclusion: The AMT flap offers all the advantages of the ALT flap without increasing donor-site
morbidity. The anterior non-committal approach keeps both the ALT and the AMT flap
options viable.
KEY WORDS
Anteromedial thigh perforator flap - chimeric flaps - freestyle perforator flap