J Korean Soc Plast Reconstr Surg.  2009 Sep;36(5):571-577.

Reconstruction of Hand using Anterolateral Thigh Fascial Free Flap

Affiliations
  • 1Department of Plastic and Reconstructive Surgery, Kwangmyung Sung-Ae General Hospital, Gyunggi-do, Korea. pskm@paran.com

Abstract

PURPOSE
The provision of thin and pliable tissue and the adequate coverage of tendon-gliding surface is necessary for a soft tissue defect of the hand with exposure of bone, tendon and muscle. This report discusses our experience with anterolateral thigh fascial free flap for the reconstruction of the soft tissue defect of the hand.
METHODS
From February 2004 to August 2008, seven patients with full-thickness soft tissue defects in the hand were reconstructed by means of a composite anterolateral thigh fascial free flap. There were soft tissue defects associated with trauma(n=5), scar contracture(n=1) and necrosis due to ischemia(n=1). The flaps were harvested from the anterolateral thigh as adipofascial flaps with only a small sheet of fascia and fatty tissue above it. The fascia and the skin of the donor site was closed directly and delayed split-thickness skin graft was performed.
RESULTS
All flaps survived completely. The size of the transferred flap ranged from 2x4cm to 5x8cm. Thin flap coverage was possible without secondary debulking operations. It left minimal donor site morbidity with a linear scar. In one case, the thigh muscle herniation in the donor site was developed.
CONCLUSION
The anterolateral thigh fascial free flap provided thin and pliable tissue which can establish a tendon-gliding mechanism, minimal bulk and minimal donor site morbidity. The disadvantages of this technique were the needs for a skin graft and the muscle herniation in donor site.

Keyword

Surgical flaps; Hand

MeSH Terms

Adipose Tissue
Cicatrix
Fascia
Free Tissue Flaps
Hand
Humans
Muscles
Necrosis
Skin
Surgical Flaps
Tendons
Thigh
Tissue Donors
Transplants
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