• Giuseppe Visconti and Marzia Salgarello.
• Department of Plastic and Reconstructive Surgery, Università Cattolica del Sacro Cuore, University Hospital A. Gemelli, Largo A. Gemelli 8, 00169 Rome, Italy. joevisconti@hotmail.com
• J Plast Reconstr Aesthet Surg. 2013 Jul 1; 66 (7): e189-92.

AbstractPrimary closure of the anterolateral thigh free flap donor site is advisable as skin grafting can be associated with higher morbidity. However, this is not possible when anterolateral thigh free flap width is over 8-9 cm with a corresponding flap width-to-thigh circumference ratio over 16%. The authors report their experience and technique with the anteromedial thigh perforator dissection during anterolateral thigh free flap donor-site closure that, on demand, can be used to design a local perforator flap to achieve primary closure of the donor site. Between July and December 2012, 20 consecutive patients underwent elective anterolateral thigh free flap reconstruction for head and neck oncologic surgery. Attempts to close directly the anterolateral thigh free flap donor site failed in two patients with large flaps and V-Y anteromedial thigh perforator flaps were advanced to close the defect. Flaps healed uneventfully. Except two patients, at least one>1-mm perforator was found in all the remaining thighs. Further investigation is needed to establish the maximum anterolateral thigh free flap donor-site width that can be served by this reconstruction. This represents an ideal model for residents to start training on perforator dissection.Copyright © 2013 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

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