Anterolateral thigh free flap: a superior solution for reconstruction of complex soft tissue defects in the distal leg and foot

Romana Parvin; M. Shahin; Mohd Fazle Rubby; M. Toriqul Islam; Mohammad Abul Kalam Azad; M. Shahidul Islam Farhad

doi:10.18203/2349-2902.isj20250553

Authors

Romana Parvin Department of Burn Plastic and Reconstructive Surgery, Enam Medical College Hospital, Dhaka, Bangladesh
M. Shahin Department of Burn Plastic and Reconstructive Surgery, National Institute of Burn and Plastic Surgery, Dhaka, Bangladesh
Mohd Fazle Rubby Department of Burn Plastic and Reconstructive Surgery, National Institute of Burn and Plastic Surgery, Dhaka, Bangladesh
M. Toriqul Islam Department of Burn and Plastic Surgery, Khulna Medical College Hospital, Khulna, Bangladesh
Mohammad Abul Kalam Azad Department of Burn Plastic and Reconstructive Surgery, National Institute of Burn and Plastic Surgery, Dhaka, Bangladesh
M. Shahidul Islam Farhad Department of Urology, Shaheed Suhrawardy Medical College Hospital, Dhaka, Bangladesh

DOI:

https://doi.org/10.18203/2349-2902.isj20250553

Keywords:

Anterolateral thigh flap, Distal leg reconstruction, Free flap reconstruction, Lower extremity defects, Soft tissue repair

Abstract

Background: Large soft tissue defects in the lower leg and foot pose significant challenges due to exposed critical structures. This study evaluates the effectiveness of the anterolateral thigh free flap for reconstructing these complex defects. The aim of the study was to assess the effectiveness of the anterolateral thigh free flap in reconstructing complex soft tissue defects in the distal leg and foot.

Methods: This prospective observational study was conducted in the department of plastic surgery at Ibn Sina Medical College Hospital, Bangladesh, from July 2022 to December 2023, involving 30 patients with complex soft tissue defects in the distal leg and foot. Participants provided informed consent, and data collected included demographics, smoking status, comorbidities, and surgical details. The ALT flap procedure included debridement, flap design, elevation, and microsurgical techniques. Postoperative care involved monitoring, splint use, and antithrombotic prophylaxis. Outcomes were analyzed using SPSS 23.

Results: Most patients undergoing ALT free flap reconstruction were male (83.33%), with a mean age of 34.83 years. Trauma was the main cause (83.34%), affecting the lower leg (36.67%). Musculocutaneous perforators (66.67%) and the posterior tibial artery (66.66%) were common. Donor site closure used split-thickness skin grafts (60.00%). Complications included wound dehiscence, partial flap necrosis, and venous congestion (6.67% each), 73.34% had excellent outcomes.

Conclusions: The anterolateral thigh free flap is highly effective for reconstructing complex soft tissue defects in the distal leg and foot, resulting in excellent functional and aesthetic outcomes for the majority of patients.

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