• The Journal of the Korean bone and joint tumor society
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• v.14 no.2
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• pp.119-124
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• 2008

Purpose: To present our experience with soft tissue reconstruction using anterolateral thigh free flap after resection of soft tissue sarcoma. Materials and Methods: Between January of 2003 and June of 2007, we treated 7 patients with soft tissue reconstruction using anterolateral thigh free flap after wide resection for soft tissue sarcoma. We retrospectively analyzed type and size of tumors, resection margin, size of defect after resection, time of operation, flap survival and complication. Results: The type of sarcoma was 3 synovial sarcoma, 2 malignant fibrous histiocytoma, 1 leimyosarcoma and 1 fibrosarcoma. The size of tumor varied from $3{\times}5\;cm$ to $7{\times}8\;cm$. The resection margins of tumors were negative in all cases. The size of soft tissue defect after resection varied from $6{\times}8\;cm$ to $15{\times}10\;cm$. The mean time of operation was 3.6 hours. All flaps were survived. Conclusion: Anterolateral thigh free flap appear to be ideal for reconstruction after wide resection of soft tissue sarcoma.

• Archives of Plastic Surgery
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• v.50 no.6
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• pp.601-609
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• 2023

Background The anterolateral thigh (ALT) flap is a preferred option in the reconstruction of a wide variety of defects, enabling multiple tissue components and thicknesses. Methods This study was conducted to investigate the correlation of the thickness of the traditional subfascial ALT flap and superficial fat flap with age, gender, and body mass index (BMI). A total of 42 patients (28 males and 14 females) were included in the study. Results Mean age was 50.2 (range, 16-75) years and mean BMI was 24.68 ± 4.02 (range, 16.5-34.7) kg/m². The subfascial flap thickness was significantly thinner in male patients (16.07 ± 2.77 mm) than in female patients (24.07 ± 3.93 mm; p < 0.05), whereas no significant difference was found between male (4.28 ± 1.15 mm) and female patients (4.85 ± 1.09 mm) regarding superficial fat flap thickness (p = 0.13). The thickness of both flaps had a positive correlation with BMI, and the strongest correlation was found for subfascial ALT thickness in female patients (r = 0.81). Age had no effect on both flap thickness measurements. The anterior thigh is thicker in women than in men, although it varies according to BMI. This shows that flap elevation is important in the superthin plane, especially if a thin flap is desired in female patients in defect reconstruction with the ALT flap. Thus, a single-stage reconstruction is achieved without the need for a defatting procedure after subfascial dissection or a second defatting procedure 3 to 6 months later. Conclusion The appropriate ALT flap plane should be selected considering the gender and BMI of the patient.

• Journal of Korean Foot and Ankle Society
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• v.11 no.2
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• pp.232-237
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• 2007

Introduction: To report the result of the thigh perforator free flap for the reconstruction of the soft tissue defect of the lower extremities and usefulness of this flap. Materials and Methods: We have performed 23 cases of thigh perforator free flap to reconstruct the soft tissue defect of the lower extremities between February 2004 and July 2005. The anterior aspect of the legs were 9 cases, the ankle joints were 4 cases, the dorsal aspect of the feet were 6 cases, the sole of the feet were 4 cases as recipient sites. The anterolateral thighs were 13 cases, the anteromedial thighs were 10 cases as donor sites. The size of the flap ranged from $4{\times}5\;cm$ to $12{\times}18\;cm$. The mean flap area was $73.2\;cm^2$. The length of the pedicle ranged from 5 cm to 15 cm. Every patient except children was operated under the spinal anesthesia. Results: 21 flaps (91.3%) survived, 2 flaps (8.7%) failed. In the 21 flaps that had survived, there were partial necrosis in 4 cases, which healed without any additional operation. In the 13 anterolateral thigh perforator flaps, 9 cases survived totally, 3 cases had the partial necrosis, 1 case failed. In the 10 anteromedial thigh perforator flaps, 8 cases survived totally, 1 case had the partial necrosis, 1 case failed. Conclusion: The authors had a good result with the thigh perforator free flap and believe that this flap is a good option for the reconstruction of the soft tissue defect of the lower extremities, because this flap has a thin thickness and it is easy to dissect the vessels. Moreover the patients can be operated with supine position.

• Archives of Craniofacial Surgery
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• v.22 no.1
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• pp.38-44
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• 2021

Background: The free flap surgical method is useful for the reconstruction of head and neck defects. This study retrospectively analyzed the results of head and neck reconstructions using various types of free flaps over the past 30 years. Methods: Between 1989 and 2018, a total of 866 free flap procedures were performed on 859 patients with head and neck defects, including 7 double free flaps. The causes of vascular crisis and salvage rate were analyzed, and the total flap survival rate calculated among these patients. Additionally, the survival and complication rates for each flap type were compared. Results: The 866 cases included 557 radial forearm flaps, 200 anterolateral thigh flaps, 39 fibular osteocutaneous flaps, and 70 of various other flaps. The incidence of the vascular crisis was 5.1%; its most common cause was venous thrombosis (52.3%). Salvage surgery was successful in 52.3% of patients, and the total flap survival rate was 97.6%. The success rate of the radial forearm flap was higher than of the anterolateral flap (p< 0.01), and the primary sites of malignancy were the tongue, tonsils, and hypopharynx, respectively. Conclusion: The free flap technique is the most reliable method for head and neck reconstruction; however, the radial forearm free flap showed the highest success rate (98.9%). In patients with malignancy, flap failure was more common in the anterolateral thigh (5.5%) and fibular (5.1%) flaps.

• Archives of Reconstructive Microsurgery
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• v.22 no.2
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• pp.90-93
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• 2013

Old post burn contractures on feet still remain challenging problem for reconstructive surgeon. A 43-year-old male visited Hallym University Sacred Heart Hospital with the complain of foot deformity and difficulties in shoe fitting. His right 4th and 5th toes were inverted at dorsal foot. We released the contracture of 4, 5th metatarsophalangeal joint and lengthened extensor tendon by Z-plasty, and covered the resultant defect with the anterolateral thigh flap. The flap was successful and the deformity was corrected. As there have been few reports on reconstruction of foot dorsum, especially on post burn extension contractures in the toes, we report a rare case of contracture release and coverage by free flap.

• Archives of Craniofacial Surgery
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• v.20 no.6
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• pp.416-420
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• 2019

Reconstruction method choice in recurrent head and neck cancer depends on surgical history, radiation therapy dosage, conditions of recipient vessels, and general patient condition. Furthermore, when defects are multiple or three dimensional in nature, reconstruction and flap choice aimed at rebuilding the functional structure of the head and neck are difficult. We experienced successful reconstruction of recurrent laryngeal cancer requiring reconstruction of esophageal and tracheostomy stroma defects using a chimeric two-skin anterolateral thigh flap with a single pedicle.

• Archives of Reconstructive Microsurgery
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• v.25 no.2
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• pp.56-59
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• 2016

Eccrine porocarcinoma is a rare malignant neoplasm of the eccrine sweat gland that often occurs in the lower extremities, and usually affects elderly individuals. Most cases of eccrine porocarcinoma arise de novo. We encountered a case of a large porocarcinoma arising in a pre-existing ganglion cyst in the knee. The malignant tumor was excised widely, and the defect was reconstructed using a free anterolateral thigh flap.

• Archives of Reconstructive Microsurgery
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• v.24 no.1
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• pp.37-39
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• 2015

Epidermal inclusion cyst is a common mass in life. It is covered with a stratified squamous epithelium, thus, there is a granular cell layer adjacent to the keratin-containing cyst lumen. It can be caused by mechanical force, trauma, or a spontaneous event. It can rupture spontaneously or be ruptured by external mechanical forces. Epidermal inclusion cysts that exhibit inflammation or recur should be removed by simple excision. In this case, the patient showed an epidermal inclusion cyst under an anterolateral thigh free flap, which can cause the palpable mass to go unnoticed. First we thought he had neuroma formation after a surgical procedure on his foot. However it was an epidermal inclusion cyst, which was diagnosed by a special pathologist. It is a curious and rare case.

• 대한두경부종양학회:학술대회논문집
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• 2003.11a
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• pp.235-235
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• 2003

• Archives of Plastic Surgery
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• v.46 no.4
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• pp.390-391
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• 2019