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Versatility of anterolateral thigh free flap n. rajacic md
- 1. VERSATILITY OF ANTEROLATERAL THIGH FREE FLAP N. Rajacic MD Al –Seef hospital Kuwait
- 3. mmmmmmmmmmm
- 4. FLAP SELECTION Recipient site requirements Availability Familiarity 4
- 5. FREE FLAPS • GROIN TEMPORALIS FASCIA • LATISSIMUS DORSI • SCAPULAR AND P.SCAPULAR FLAP SERRATUS FASCIA • RADIAL AND ULNAR FOREARM FIBULA FLAP • DELTOID FLAP • LATERAL ARM ILIAC CREST • TRAM JEJUNAL FLAP • TFL • DORSALIS PEDIS OMENTAL FLAP • … …
- 6. ANTEROLATERAL THIGH FLAP SONG 1984 Fu-Chan-Wei Koshima
- 7. VASCULAR ANATOMY DESCENDING BRANCH OF LCFA SEPTOCUTANEOUS PERFORATORS (12-32%) MUSCULOCUTANEOUS PERFORATORS
- 8. Transverse branch Nerve for m. Vastus lat. LCFA Descending branch m. Vastus. lat
- 9. m. Rectus femoris Descending branch LCFA Septocutaneous branch LCFA
- 11. Perforating branch m. Vastus lateralis Descending branch of LCFA m. Rectus femoris
- 13. PREOPERATIVE REQUIREMENT •NO NEED OF ANGIOGRAPHY •DETECTION OF PERFORATOR BY DOPPLER FLOWMETER IS ESSENTIAL
- 14. Spina iliaca anterior superior PLANING OF THE FLAP Patella
- 15. COMPOSITION MUSCLE MUSCLE +SKIN FASCIOCUTANEOUS ULTRATHIN SKIN FLOW-THROUGH FLAP FUNC. MUSCLE TRANSFER VASC. NERVE GRAFT
- 16. MUSCLE FLAP m. Rectus femoris TFL m. Vastus lat.
- 34. THINING OF THE FLAP 0,5 cm
- 40. SHAPING OF THE FLAP DEEPITHELIASATION INNER LINING OUTER COVER
- 44. Combined flap- chimeric principle
- 58. ADVANTAGES DISADVANTAGES • SAFE AND EASY ELEVATION • VARIABLE ANATOMY • LONG VASCULAR PEDICLE (10-12cm) • DONOR SITE GRAFTING IN CASE OF • LARGE CALIBER VESSEL (2mm) LARGE FLAPS ( MORE THAN 10 cm) • LARGE DONOR FLAP AREA (30X18cm) • HAIRY SKIN IN MALES • POSSIBILITY OF THINNING THE FLAP • MINIMAL DONOR SITE MORBIDITY • POSSIBILITY OF MULTIPLE FLAPS ON THE SAME PEDICLE (CHIMERIC PRINCIPLE) • NO NEED TO CHANGE POSITION OF THE PATINET (SUPINE POSITION)
- 59. CONCLUSION ANTEROLATERAL FLAP IS EXTREMELY RELIABLE FLAP FOR THE RECONSTRUCTIONS OF VARIOUS DEFECTS DUE TO GOOD LENGTH AND SIZE OF PEDICLE, LARGE AMOUNT OF TISSUE OF DESIRABLE THICKNESS AND COMPOSITION , EASY DISSECTION AND MINIMAL DONOR SITE MORBIDITY