De-epithelialised anterior (anterolateral and anteromedial) thigh flaps for dead space filling and contour correction in head and neck reconstruction

Anterior (anterolateral and anteromedial) thigh flaps based on the descendi ng branch of the lateral circumflex femoral vessels provide a long vascular pedicle and a large flap without sacrificing main vessels and muscles. Twe nty-eight de-epithelialised anterior thigh flaps were transferred for recon struction of head and neck defects following tumour ablation. Two flaps wer e lost in patients that had previously undergone high-dose radiotherapy fol lowing free tissue transfer. Vascularised fibula, vascularised iliac bone a nd other tissues were combined with anterior thigh flaps in 13 cases utilis ing the distal end or derivative branches of the vascular pedicle. Salivary fistula was seen in only one case, although there were many minor and majo r complications. In five cases, double skin flaps were harvested from the i psilateral thigh. One of these flaps was used for coverage of intraoral def ects, while the other was placed in the submandibular area to fill dead spa ce. Compared with other methods, this multi-nap method is considered to be most suitable for dead space filling and contour correction.