Reconstruction of Tissue Defects with Anterolateral Thigh Sensate Free Flap

ABSTRACT

As the use of free tissue reconstruction becomes more routine, attention is being focused not only on flap survival, but also on functional refinements in these flaps. One of the more important aspects of improving the outcome of these reconstruction may relate to the return of sensation. The anterolateral thigh free flap is based on the descending branch of the lateral circumflex femoral artery. This fasciocutaneous flap is indicated whenever a relatively thin flap is required in reconstruction. A neurosensory flap can be employed based on the anterior branched of the lateral femoral cutaneous nerve of the thigh. Since 1996, 15 patients with soft tissue defect on various regious were treated by using the anterolateral thigh sensate free falp. All flaps survived without total loss. Anastomosis of the sensible nerve on the recipient site with the anterior branch of the lateral femoral cutaneous nerve of the thigh was performed. All patients showed recovery of sensation in the anterolateral thigh sensate free falp beginning between the 4th and 6th month postoperatively. Follow-up periods ranged from 8 to 34 months and the results of sensory recovery were satisfactory. Therefore, resensitization of an anterolateral thigh free flap should be attempted by a nerve anastomosis in this transplant. The longterm success in this study suggests the benefits of microsurgical neurotization in free tissue transplantation.