• Zhijin Liu, Shengzhe Liu, Lin Yang, Junnan Cheng, Tao Zhang, Qinfeng Gao, Chengpeng Yang, Yongtao Huang, Fengwen Sun, and Jihui Ju.
• Department of Hand Surgery, Suzhou Ruihua Orthopedic Hospital, Suzhou, China.
• Injury. 2023 Oct 1; 54 (10): 110979110979.

IntroductionLimb salvage in large wounds is difficult because the disrupted blood supply does not support a flap. This study evaluated the clinical efficacy of using two flow-through anterolateral thigh perforator flaps for reconstructing large-area limb wounds.MethodsThis retrospective study included 45 patients who underwent reconstruction of large limb wounds using two flow-through anterolateral thigh perforator flaps at Ruihua Hospital between January 2015 and December 2020. Wound areas ranged from 15 cm × 13 cm to 46 cm × 18 cm. Single flap areas ranged from 16 cm × 8 cm to 46 cm × 9 cm. Blood supply locations were identified using color Doppler ultrasound or digital subtraction angiography (DSA) images. Primary outcomes were flap survival and complications at recipient or donor sites during at least 6-months follow-up.ResultsThe overall flap survival rate was 97% (87/90). All donor sites healed by first intention. Three cases developed vascular crises, which were alleviated by reoperation. One case had flexor contracture in left toes, relieved by cutting flexor tendons; 13 cases had flap bloat, relieved by flap thinning at 6 months. All cases showed properly healed wounds and functional reconstruction.ConclusionsReconstruction of large-area limb wounds using two flow-through anterolateral thigh perforator flaps provides safe and satisfactory effects without donor-site morbidity, and with proper healing and restored function.Copyright © 2023. Published by Elsevier Ltd.

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