Anterolateral thigh flap for abdominal wall reconstruction

The free or pedicled anterolateral thigh flap was introduced for the recons truction of large abdominal wall defects. This flap is superior to the tens or fasciae latae musculocutaneous flap in several respects. These include t he wide, reliable skin territory (which can reach the level of the knee) an d the long pedicle. Therefore, a pedicled anterolateral thigh flap with rel iable blood circulation can easily be positioned above the umbilicus. In ad dition, the free anterolateral thigh flap has greater freedom of orientatio n and can be used to repair larger abdominal wall defects than can the tens or fasciae latae flap. Seven patients in whom abdominal wall defects had been reconstructed with p edicled or free anterolateral thigh flaps were reviewed. Their average age was 47.1 years (range, 21 to 74 years), and the average follow-up period wa s 10.7 months (range, 2 to 21 months). The size of the abdominal wall defec ts ranged from 12 X 12 cm to 18 X 24 cm, and the size of the transferred fl ap ranged from 10 X 20 cm to 20 X 20 cm. Three flaps were pedicled ana four were free, of which three incorporated the tensor fasciae latae flap. All flaps survived completely, and no postoperative abdominal hernias developed . Despite some variations in vascular anatomy and technical difficulties in e levating the anterolateral thigh flap, the authors conclude that the pedicl ed or free anterolateral thigh flap is superior to the tensor fasciae latae flap for reconstruction of large abdominal wall defects.