Comprehensive assessment of the donor-site of the anterolateral thigh flap: A prospective study in 33 patients

Background: The anterolateral thigh (ALT) free flap has been an extremely versatile flap. The purpose of this study was to propose comprehensive functional assessments of the donor site. Methods: A total of 33 ALT flaps were enrolled prospectively. Objective assessments included isokinetic testing of the knee, and electromyographic examination of the lateral femoral cutaneous nerve (LFCN). The Patient and Observer Scar Assessment Scale (POSAS) was used to subjectively assess the donor-site scar. Results: On the donor side, a significant decrease in most isokinetic muscle strength values was obvious 1 year postoperatively (P<. 01). The normal side showed a compensatory increase 1 year postoperatively in the majority of isokinetic muscle strength values (P<. 05). The majority of patients (70%) showed decreased sensory conduction velocity of the LFCN or no response to the microcurrent stimulation postoperatively. The aesthetic outcome was satisfactory. Conclusion: The decline in functional parameters at the donor-site was common. However, much more research is needed.