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Lateral Circumflex Femoral Artery System as a Universal Donor Area For Free Flaps – A Single Surgeons Experience
Tahsin Oguz Acarturk
University of Pittsburgh / Div of Plastic Surgery
2012-02-15
Presenter: Tahsin Oguz Acarturk
Affidavit:
Director Name:
Author Category: Attending
Presentation Category: Clinical
Abstract Category: General Reconstruction
How does this presentation meet the established conference educational objectives?
This will provide information on the ALT - vastus lateralis flaps used for multipurpose reconstruction for various indications for all areas of the body. Many modifications are also introduced.
How will your presentation be used by practicing physicians in the audience?
This donor area is underutilized in many centers. The audiance will find this information useful to chance their practice.
Introduction: Anterolateral thigh (ALT) flap based on the lateral circumflex femoral artery (LCFA) system has become the ''universal'' donor area for many surgeons. Many modifications and indications have been described. We present our experience with this versatile donor area.
Patient/Methods: Fifty five patients (age range 6-75 years) underwent reconstruction with free flaps from the LCFA system. Twenty-eight were lower extremity, twenty-one were head and neck and six were upper extremity reconstructions. Flaps were; 28 ALT, 19 vastus lateralis myocutaneous , 5 vastus lateralis muscle , 2 tensor fascia lata perforator, and 1 ALT with vastus intermedius and femur. Several technical modifications and versatilities included tissue expansion before flap harvest, chimeric flaps, nerve coaptation for sensation, flap thinning, complete deepithalization, inclusion of fascia lata for functional tendon reconstruction, flow-thru anastomosis, segmental muscle harvest and inclusion of bone.
Results: The size of flaps ranged from 4x7cm to 17x28cm. There were 3(5%) flap failures, all of which were lower extremity. 17 patients required skin grafting for donor area closure. There was only one major donor site complications in a diabetic patient. None indicated weakness at ambulation in long term follow up.
Conclusion: LCFA system offers familiar anatomy, easy positioning, two-team surgery, fast flap harvest, low morbidity. Tissues harvested from this area are skin, fat, fascia, muscle and bone, alone or in combination as composite or chimeric flaps. This system is by far the most versatile and universal of all donor areas, which in turn can be adapted for multiple indications.
