The anterolateral thigh as a universal donor site for soft tissue reconstruction in maxillofacial surgery

SummaryObjectiveThe experience with 191 flaps from the anterolateral thigh is described with special regard to variations of vascular anatomy and possible flap designs.PatientsSince 1992, 191 flaps from the anterolateral thigh donor site were used in 187 patients. The size of the defects varied from 3×5 cm to 21×10 cm, being located in nearly all areas of the head and neck region including the skull base.MethodsThe functional and aesthetic outcome was routinely evaluated during follow-up of the patients. All complications and secondary procedures were documented during the whole follow-up period ranging from 4 weeks to 11.2 years.ResultsSix different patterns of variations were observed concerning the flap pedicle, but none of these resulted in failure of flap raising except for two patients, in whom no perforators could be found. Poor functional results were observed in 17 patients, and debulking procedures or scar revisions were carried out in 58 of the 187 patients. Nine flap types reaching from voluminous and large myocutaneous flaps to ultra-thin cutaneous perforator flaps were used, enabling closure of virtually any type of soft tissue defect. Twelve flaps were lost, resulting in a success rate of 93.7%.ConclusionDue to the combined advantages of minimal donor site morbidity, the option of simultaneous flaps and the satisfying results, the anterolateral thigh can be considered a universal donor site which is ideally suited for soft tissue reconstruction in cranio-maxillofacial surgery.