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A Journal on Surgery

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Minerva Chirurgica 2008 August;63(4):283-8


language: English

Anatomical study of lateral circumflex femoral arterial system for the anterolateral thigh flap

Fathi M. 1, Reza Fathi H. 1, Hatamipour E. 1, Abbasi A. 2

1 Department of Plastic and Reconstructive Surgery Imam Hospital, Medical Sciences/ University of Tehran, Tehran, Iran 2 Department of Basic and Clinical Research Tehran Heart Center, Medical Sciences/ University of Tehran, Tehran, Iran


Aim. The aim of this study was to increase anatomical knowledge of anterolateral thigh (ALT) flap, vascular system nourishing the flap.
Methods. Forty thighs of 20 male cadavers of Iranian origin were examined. A total of 189 perforators were identified, mainly as musculocutaneous perforators (89.9%), usually in the middle third of the thigh and arising from the descending branch of the lateral circumflex femoral artery (DLCFA).
Results. The mean length of superior and inferior pedicles was 9.2 cm and 4.23 cm, respectively. The caliber of the descending artery and one of its accompanying veins was averagely 2.8 and 3.0 mm, respectively. In 85% of the ALT flaps, the DLCFA connected with the lateral superior genicular artery (SGA).
Conclusion. These findings suggest that the number of septocutaneous is less than that of the musculocutaneous perforators in the ALT region. This new consideration of ALT flap perforators makes it possible to elevate a vital flap in a greater number of cases, but it requires a longer and more difficult surgical technique to dissect perforators through the muscles. The distally based ALT flap is a good option for coverage of soft-tissue defects around the knee. Additionally, a potentially supercharged ALT flap may be applied in respect to the superior and inferior pedicles.

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