Free Transplantation Of Anterolateral Femoral Skin Flap Forrepair Of Soft Tissue Defects In The Distal Part Of Lower Extremities

objective:To discuss the key point of surgery skills and clinical effect of the use of anterolateral thigh skin flap for the repair of soft tissue defects in the distal part of extremities.Methods:Retrospective analysis of a total of 37 cases with soft tissue defects in the distal part of extremities repaired by the transplantation of anterolateral thigh flap,including 31 male and 6 female cases,aged from 19 to 54 years old.the flaps were 13cm×7cm to 32cm×20cm in size.in those cases,14 cases with the lataneous femoral cutaneous nerve anastomosis,and 2 cases with the primary repair of the flap.all cases were followed up,and the shape and function of the flap were closely observed after the surgery.Results:34 flaps survived perfectly,3 flaps survived with partial necrosis in the marginal part,2 flaps covered the defect part completely after secondary repair with the removal of the redundant fat tissue,1flap healed after changing dressings and the transplantation of the full thick skin graft.those cases with anastomosis of lateral femoral cutaneous nerve got better recovery of the sense than those without the anastomosis.all cases were followed up from 6 to 12 months.there were not any serious adverse effects in all cases ,and the function and shape of the flaps were satisfying.Conclusion:Anterolateral thigh skin flap has the good quality of suitable thickness , good concealment,easy and safe operation ,protection of the main blood vessal and nerves,less injury of lower extremity,large flap supply and active design according to the recipient sites.the ultrathin flap made in the operation overcome the disadvantage of clumsy and swelling shape of the flap and the need of secondary repair.anterolateral thigh skin flap is suitable for the repair of defect of lower extremity and ankle,especially for those with large exposure of skeleton,tendon,blood vessels and nerves.