Application of Thinned Anterolateral Thigh Flap for the Reconstruction of Head and Neck Defects

Purpose: To evaluate the feasibility and reconstructive efficacy of the thinned anterolateral thigh (ALT) flap for the reconstruction of head and neck defects. Patients and Methods: A retrospective review was performed of 43 patients who had undergone reconstruction of head and neck defects with a thinned ALT flap from January 2009 through December 2013 at the Second Xiangya Hospital. The methods for flap thinning and defect reconstruction and reconstructive efficacy are reported. Results: The flaps were 5 cm x 7 cmto 9 cm x 14 cm, and all were harvested from a single cutaneous perforator. Postoperatively, 40 flaps survived completely and 3 flaps experienced partial necrosis. Venous compromise occurred in 2 cases, both of which were salvaged after operative exploration. Of the 43 donor sites, 41 were closed directly and resulted in only linear scars, and 2 were closed using full-thickness skin grafts because the defect was larger. All the patients were followed for approximately 6 to 36 months, and they were satisfied with the esthetic and functional results of the donor and recipient sites after reconstruction. Conclusion: With the high success rate of flap transplantation, satisfactory functional and esthetic results, and lower complication rates at the donor and recipient sites, the use of thinned ALT flaps can be a good choice for the reconstruction of head and neck defects in obese patients. (C) 2015 American Association of Oral and Maxillofacial Surgeons