Arch Plast Surg.  2012 Jul;39(4):367-375. 10.5999/aps.2012.39.4.367.

Lower Extremity Reconstruction Using Vastus Lateralis Myocutaneous Flap versus Anterolateral Thigh Fasciocutaneous Flap

• Lee MJ
• Yun IS
• Rah DK
• Lee WJ

• KMID: 2120691
• DOI: http://doi.org/10.5999/aps.2012.39.4.367

Abstract

BACKGROUND
The anterolateral thigh (ALT) perforator flap has become a popular option for treating soft tissue defects of lower extremity reconstruction and can be combined with a segment of the vastus lateralis muscle. We present a comparison of the use of the ALT fasciocutaneous (ALT-FC) and myocutaneous flaps.
METHODS
We retrospectively reviewed patients in whom free-tissue transfer was performed between 2005 and 2011 for the reconstruction of lower extremity soft-tissue defects. Twenty-four patients were divided into two groups: reconstruction using an ALT-FC flap (12 cases) and reconstruction using a vastus lateralis myocutaneous (VL-MC) flap (12 cases). Postoperative complications, functional results, cosmetic results, and donor-site morbidities were studied.
RESULTS
Complete flap survival was 100% in both groups. A flap complication was noted in one case (marginal dehiscence) of the ALT-FC group, and no complications were noted in the VL-MC group. In both groups, one case of partial skin graft loss occurred at the donor site, and debulking surgeries were needed for two cases. There were no significant differences in the mean scores for either functional or cosmetic outcomes in either group.
CONCLUSIONS
The VL-MC flap is able to fill occasional dead space and has comparable survival rates to ALT-FC with minimal donor-site morbidity. Additionally, the VL-MC flap is easily elevated without myocutaneous perforator injury.

Keyword

Free tissue flaps; Lower extremity; Quadriceps muscle

MeSH Terms

Cosmetics
Free Tissue Flaps
Humans
Lower Extremity
Muscles
Perforator Flap
Postoperative Complications
Quadriceps Muscle
Retrospective Studies
Skin
Survival Rate
Thigh
Tissue Donors
Transplants
Cosmetics