Archives of Plastic Surgery

Korean Society of Plastic and Reconstructive Surgeons (대한성형외과학회)
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TFL Perforator Flap Complementing and Completing the ALT-AMT Flap Axis

  • Dushyant Jaiswal (Department of Plastic and Reconstructive Surgery, Tata Memorial Hospital, Homi Bhabha National Institute) ;
  • Bharat Saxena (Department of Plastic and Reconstructive Surgery, Nanavati Max Super Speciality Hospital) ;
  • Saumya Mathews (Department of Plastic and Reconstructive Surgery, Tata Memorial Hospital, Homi Bhabha National Institute) ;
  • Mayur Mantri (Department of Plastic and Reconstructive Surgery, Tata Memorial Hospital, Homi Bhabha National Institute) ;
  • Vineet Pilania (Department of Plastic and Reconstructive Surgery, Tata Memorial Hospital, Homi Bhabha National Institute) ;
  • Ameya Bindu (Department of Plastic and Reconstructive Surgery, Tata Memorial Hospital, Homi Bhabha National Institute) ;
  • Vinay Kant Shankhdhar (Department of Plastic and Reconstructive Surgery, Tata Memorial Hospital, Homi Bhabha National Institute) ;
  • Prabha Yadav (Department of Plastic and Reconstructive Surgery, Tata Memorial Hospital, Homi Bhabha National Institute)
  • Received : 2023.08.25
  • Accepted : 2024.04.21
  • Published : 2024.07.15
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Abstract

Background Anterolateral thigh (ALT) flap is the most common soft tissue flap used for microvascular reconstruction of head and neck. Its harvest is associated with some unpredictability due to variability in perforator characteristics, injury or unfavorable configuration for complex defects. Anteromedial thigh (AMT) flap is an option, but the low incidence and thickness restrict its utility. Tensor fascia lata (TFL) perforator (TFLP) flap is an excellent option to complement ALT. Its perforator is consistent, robust, in vicinity, and lends itself with the ALT perforator. Methods This study was an analysis of 29 cases with a free flap for head neck reconstruction with an element of TFLP flap from July 2017 to May 2021. Results All cases were primarily planned for an ALT reconstruction. There was absence of the ALT perforator in 16 cases but a sizable TFL perforator was available. In 13 cases, the complex defect warranted use of both ALT plus TFL in a conjoint (5), chimeric (5), and multiple (3) free flaps manner. Most common perforator location was septocutaneous between the TFL and gluteus medius. There was complete flap loss in two cases and partial necrosis in two. No adjuvant therapy was delayed. Conclusion TFLP can reliably complement the ALT/AMT axis. Chimeric ALT-TFL can be harvested for large, complex, multicomponent, and multidimensional defects.

Keywords

References

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