Free Transplantation Of Anterolateral Femoral Skin Flap For Repair Of Soft Tissue Defects In The Distal Part Of Extremities

Objective: To explore an ideal operative type of free transplantation of anterolateral femoral skin flap for repair of soft tissue defects in the distal part of extremities.Methods: 53 cases with soft tissue defects in the distal part of extremities were treated by means of free transplantation of anterolateral femoral skin flaps since July 1999. The patients aged from 13 to 59 years old, 47 male and 6 female patients .The area of soft tissue defects ranged from 14 cm x 5cm to 25 cm x 14 cm, the flaps were 16 cm x 7 cm to 27 cm x 17 cm in size. Lateral femoral cutaneous nerve was sutured with a cutaneous nerve of receptive site in 36 cases. All the cases were followed up postoperatively from 6 months to 4 years and 2 months . The shape. circulation and the restoration of sensation of the flaps were observed and studied.Results: 47 flaps survived perfectly , 4 flaps survived with partial necrosis and healed after changing dressings or skin graft, 2 flaps failed to survive and were replaced by free latissimus dorsi myocutaneous flaps. Out of 34 cases (excluding 2 cases with failure) 30 were satisfactory with restoration of protective sensation due to the anastomosis of lateral femoral cutaneousnerve and a skin nerve of the receptive site, only 2 cases got the similar results in 17 cases without cutaneous nerve anastomosis. The results were significantly different between two groups (P<0.001) . In female and fat male patients, the shape of flap was obese commonly. 51 flaps were good in circulation, 2 flaps located under the foot survived with local chronic necrosis.Conclusion: Free transplantation of anterolateral femoral skin flap is relatively an good operative type for the repair of soft tissue defects in the distal part of extremities as it possesses the advantages of large flap area , hiding of donor site, simple dissection, reliable blood supply, satisfactory restoration of sensation after skin nerves anastomosis, neither major nerve nor major blood vessel is killed, but in female and fat male patients, the shape of flaps was somewhat obese generally.Free transplantation of anterolateral femoral skin flap companied with the anastomosis of the lateral femoral cutaneous nerve and a skin nerve of receptor site is relatively an ideal operative type for the repair of soft tissue defects in the distal part of extremities.