Aesthetic Outcome After Reconstruction of Complex Soft Tissue Defects with Free Antero-Lateral Thigh Flap Using Simple Equipment

Ashraf H. Abbas; Moustafa Elmasry; Ingrid Steinvall; Osama A. Adly; Mohamed A. Elbadawy; Taha Ali Moati; Folke Sjöberg

doi:doi:10.11648/j.js.s.2015030201.18

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Aesthetic Outcome After Reconstruction of Complex Soft Tissue Defects with Free Antero-Lateral Thigh Flap Using Simple Equipment

Ashraf H. Abbas, Moustafa Elmasry, Ingrid Steinvall, Osama A. Adly, Mohamed A. Elbadawy, Taha Ali Moati, Folke Sjöberg

Published in Journal of Surgery (Volume 3, Issue 2-1)

Received: 7 February 2015 Accepted: 13 February 2015 Published: 9 May 2015

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Abstract

Aim: We aimed to assess the aesthetic outcome of surgical reconstruction by free ALT flap using binocular single-refraction magnifying glasses and a modified post- operative surveillance protocol.Methods: 16 patients were operated for free antero-lateral thigh flap to reconstruct complex soft tissue defects with a close clinical follow up protocol for post operative care depending on the attending personnel in the Plastic surgery unit, Suez Canal University hospital, Ismailia, Egypt. Aesthetic outcome was assessed using a questionnaire based on Posch et al. 2005, including the following itemscolour, contour, presence of hair, overall appearance and donor site scar.Results:The patients’ assessed aesthetic outcome was acceptable in majority of the cases; median score was 4 for all assessed items. Complete flap loss occurred in one case, other complications as arterial thrombosis and hematomas and infection were detected and managed accordingly with flap salvage in the 3 complicated cases.Conclusion:The result suggests that the proposed protocol is sufficient as an alternative. The aesthetic outcome assessed by the patient and the failure rate was in line with other studies.

Published in	Journal of Surgery (Volume 3, Issue 2-1) This article belongs to the Special Issue Postoperative Pain Syndrome
DOI	10.11648/j.js.s.2015030201.18
Page(s)	36-41
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2015. Published by Science Publishing Group

Keywords

Free Flap Surgery, Free Antero-Lateral Thigh Flap, Binocular Single Refraction Magnifying Glasses, Aesthetic Outcome

References

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[2]	Christopher J. Salgado, Harvey Chim, ShaylaSchoenoff, P.A.-C. and Samir Mardini,Postoperative care and monitoring of the reconstructed head and neck patient. Seminars in Plastic surgery (2010) / Vol. 24, Number. 3:281-287.
[3]	Song YG, Chen GZ, Song YL. The free thigh flap: A new free flap concept based on the septocutaneous artery. Br J PlastSurg. 1984;37:149–159.
[4]	Demirkan F, Chen HC, Wei FC et al. (2000). The versatile anterolateral thigh ﬂap: a musculocutaneousﬂap in disguise in head and neck reconstruction. British Journal of Plastic Surgery, 53: 30–36.
[5]	Kimata Y, Uchiyama K, Ebihara S et al. (1997). Versatility of the free anterolateral thigh ﬂap for reconstruction of head and neck defects. Archives of Otolaryngology, Head and Neck Surgery, 123:1325–1331.
[6]	Koshima I, Fukuda H, Yamamoto H, Moriguchi T, Soeda S, Ohta S (1993a). Free anterolateral thigh ﬂaps for reconstruction of head and neck defects. Plastic and Reconstructive Surgery, 92: 421–430,\ Koshima I, Yamamoto H, Hosoda M, Moriguchi T, Orita Y, Nagayama H (1993b). Free combined composite ﬂaps using the lateral circumﬂex femoral system for repair of massive defects of the head and neck regions: an introduction to the chimeric ﬂap principle. Plastic and Reconstructive Surgery, 92: 411–420.
[7]	Luo S, Raﬀoul W, Luo J, Gao J, Chen L, Egloﬀ DV (1999). Anterolateral thigh ﬂap; a review of 168 cases. Microsurgery, 19: 232–238.
[8]	Fu-Chan Wei, Vivekjain, NaciCelik, Hung-chi chen, David chewi-chin chuang and chih-hunglin.(2002), Have we found an ideal soft-tissue flap? An experience with 672 Anterolateral thigh flaps, PlastReconstr Surg. June 2002;2219-2226.
[9]	Abd El-hamid Abdel-khalek; Abdul-Mohsen Allam; Amgad Hendy; Sayed Abdel-Razek; HashemAyad; SobhyHweidy; HelmyShalaby and MoustafaHegazy, Clinical Evaluation of Free Anterolateral Thigh Flap in the Reconstruction of Major Soft Tissue Defects in the Leg and Foot. Egypt. J. Plast. Reconstr. Surg., Vol. 27, No. 2, July: 173-180, 2003.
[10]	Wei, F. C., Demirkan, F., Chen, H. C., et al. Double free flapsin reconstruction of extensive composite mandibular defectsin head and neck cancer. Plast. Reconstr. Surg. 103: 39, 1999.
[11]	Gabr, E., Kobayashi, M. R., Salibian, A. H., et al. Mandibularreconstruction: Are two flaps better than one? Ann. Plast.Surg. 52: 31, 2004.
[12]	Jeng, S. F., Kuo, Y. R., Wei, F. C., et al. Reconstruction of extensive composite mandibular defects with large lip involvementby using double free flaps and fascia lata grafts for oral sphincters. Plast. Reconstr. Surg. 115: 1830, 2005.
[13]	Mureau MA, Posch NA, Meeuwis CA, Hofer SO. Anterolateral thigh flap reconstruction of large external facial skin defects: a follow-up study on functional and aesthetic recipient- and donor-site outcome. Plastic and reconstructive surgery 2005; 115: 1077-1086.
[14]	Posch NA, Mureau MA, Flood SJ, Hofer SO. The combined free partial vastuslateralis with anterolateral thigh perforator flap reconstruction of extensive composite defects. British journal of plastic surgery 2005; 58: 1095-1103.
[15]	Posch NA, Mureau MA, Dumans AG, Hofer SO. Functional and aesthetic outcome and survival after double free flap reconstruction in advanced head and neck cancer patients. Plastic and reconstructive surgery 2007; 120: 124-129.

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APA Style

Ashraf H. Abbas, Moustafa Elmasry, Ingrid Steinvall, Osama A. Adly, Mohamed A. Elbadawy, et al. (2015). Aesthetic Outcome After Reconstruction of Complex Soft Tissue Defects with Free Antero-Lateral Thigh Flap Using Simple Equipment. Journal of Surgery, 3(2-1), 36-41. https://doi.org/10.11648/j.js.s.2015030201.18

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ACS Style

Ashraf H. Abbas; Moustafa Elmasry; Ingrid Steinvall; Osama A. Adly; Mohamed A. Elbadawy, et al. Aesthetic Outcome After Reconstruction of Complex Soft Tissue Defects with Free Antero-Lateral Thigh Flap Using Simple Equipment. J. Surg. 2015, 3(2-1), 36-41. doi: 10.11648/j.js.s.2015030201.18

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AMA Style

Ashraf H. Abbas, Moustafa Elmasry, Ingrid Steinvall, Osama A. Adly, Mohamed A. Elbadawy, et al. Aesthetic Outcome After Reconstruction of Complex Soft Tissue Defects with Free Antero-Lateral Thigh Flap Using Simple Equipment. J Surg. 2015;3(2-1):36-41. doi: 10.11648/j.js.s.2015030201.18

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@article{10.11648/j.js.s.2015030201.18,
  author = {Ashraf H. Abbas and Moustafa Elmasry and Ingrid Steinvall and Osama A. Adly and Mohamed A. Elbadawy and Taha Ali Moati and Folke Sjöberg},
  title = {Aesthetic Outcome After Reconstruction of Complex Soft Tissue Defects with Free Antero-Lateral Thigh Flap Using Simple Equipment},
  journal = {Journal of Surgery},
  volume = {3},
  number = {2-1},
  pages = {36-41},
  doi = {10.11648/j.js.s.2015030201.18},
  url = {https://doi.org/10.11648/j.js.s.2015030201.18},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.js.s.2015030201.18},
  abstract = {Aim: We aimed to assess the aesthetic outcome of surgical reconstruction by free ALT flap using binocular single-refraction magnifying glasses and a modified post- operative surveillance protocol.Methods: 16 patients were operated for free antero-lateral thigh flap to reconstruct complex soft tissue defects with a close clinical follow up protocol for post operative care depending on the attending personnel in the Plastic surgery unit, Suez Canal University hospital, Ismailia, Egypt. Aesthetic outcome was assessed using a questionnaire based on Posch et al. 2005, including the following itemscolour, contour, presence of hair, overall appearance and donor site scar.Results:The patients’ assessed aesthetic outcome was acceptable in majority of the cases; median score was 4 for all assessed items. Complete flap loss occurred in one case, other complications as arterial thrombosis and hematomas and infection were detected and managed accordingly with flap salvage in the 3 complicated cases.Conclusion:The result suggests that the proposed protocol is sufficient as an alternative. The aesthetic outcome assessed by the patient and the failure rate was in line with other studies.},
 year = {2015}
}

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TY  - JOUR
T1  - Aesthetic Outcome After Reconstruction of Complex Soft Tissue Defects with Free Antero-Lateral Thigh Flap Using Simple Equipment
AU  - Ashraf H. Abbas
AU  - Moustafa Elmasry
AU  - Ingrid Steinvall
AU  - Osama A. Adly
AU  - Mohamed A. Elbadawy
AU  - Taha Ali Moati
AU  - Folke Sjöberg
Y1  - 2015/05/09
PY  - 2015
N1  - https://doi.org/10.11648/j.js.s.2015030201.18
DO  - 10.11648/j.js.s.2015030201.18
T2  - Journal of Surgery
JF  - Journal of Surgery
JO  - Journal of Surgery
SP  - 36
EP  - 41
PB  - Science Publishing Group
SN  - 2330-0930
UR  - https://doi.org/10.11648/j.js.s.2015030201.18
AB  - Aim: We aimed to assess the aesthetic outcome of surgical reconstruction by free ALT flap using binocular single-refraction magnifying glasses and a modified post- operative surveillance protocol.Methods: 16 patients were operated for free antero-lateral thigh flap to reconstruct complex soft tissue defects with a close clinical follow up protocol for post operative care depending on the attending personnel in the Plastic surgery unit, Suez Canal University hospital, Ismailia, Egypt. Aesthetic outcome was assessed using a questionnaire based on Posch et al. 2005, including the following itemscolour, contour, presence of hair, overall appearance and donor site scar.Results:The patients’ assessed aesthetic outcome was acceptable in majority of the cases; median score was 4 for all assessed items. Complete flap loss occurred in one case, other complications as arterial thrombosis and hematomas and infection were detected and managed accordingly with flap salvage in the 3 complicated cases.Conclusion:The result suggests that the proposed protocol is sufficient as an alternative. The aesthetic outcome assessed by the patient and the failure rate was in line with other studies.
VL  - 3
IS  - 2-1
ER  -

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Author Information

Ashraf H. Abbas

Plastic Surgery Unit, Surgery Dept., Suez Canal University, Ismailia, Egypt
Moustafa Elmasry

Plastic Surgery Unit, Surgery Dept., Suez Canal University, Ismailia, Egypt and The Burn Centre Dept. of Hand and Plastic Surgery and, Dept. of Clinical and Experimental Medicine, Link?ping University, Link?ping, Sweden
Ingrid Steinvall

Burn Centre Department of Hand and Plastic Surgery, Link?ping University, Link?ping, Sweden
Osama A. Adly

Plastic Surgery Unit, Surgery Dept., Suez Canal University, Ismailia, Egypt
Mohamed A. Elbadawy

Plastic Surgery Unit, Surgery Dept., Suez Canal University, Ismailia, Egypt
Taha Ali Moati

General Surgery department, Suez Canal University, Ismailia, Egypt
Folke Sjöberg

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APA Style

Ashraf H. Abbas, Moustafa Elmasry, Ingrid Steinvall, Osama A. Adly, Mohamed A. Elbadawy, et al. (2015). Aesthetic Outcome After Reconstruction of Complex Soft Tissue Defects with Free Antero-Lateral Thigh Flap Using Simple Equipment. Journal of Surgery, 3(2-1), 36-41. https://doi.org/10.11648/j.js.s.2015030201.18

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ACS Style

Ashraf H. Abbas; Moustafa Elmasry; Ingrid Steinvall; Osama A. Adly; Mohamed A. Elbadawy, et al. Aesthetic Outcome After Reconstruction of Complex Soft Tissue Defects with Free Antero-Lateral Thigh Flap Using Simple Equipment. J. Surg. 2015, 3(2-1), 36-41. doi: 10.11648/j.js.s.2015030201.18

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AMA Style

Ashraf H. Abbas, Moustafa Elmasry, Ingrid Steinvall, Osama A. Adly, Mohamed A. Elbadawy, et al. Aesthetic Outcome After Reconstruction of Complex Soft Tissue Defects with Free Antero-Lateral Thigh Flap Using Simple Equipment. J Surg. 2015;3(2-1):36-41. doi: 10.11648/j.js.s.2015030201.18

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@article{10.11648/j.js.s.2015030201.18,
  author = {Ashraf H. Abbas and Moustafa Elmasry and Ingrid Steinvall and Osama A. Adly and Mohamed A. Elbadawy and Taha Ali Moati and Folke Sjöberg},
  title = {Aesthetic Outcome After Reconstruction of Complex Soft Tissue Defects with Free Antero-Lateral Thigh Flap Using Simple Equipment},
  journal = {Journal of Surgery},
  volume = {3},
  number = {2-1},
  pages = {36-41},
  doi = {10.11648/j.js.s.2015030201.18},
  url = {https://doi.org/10.11648/j.js.s.2015030201.18},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.js.s.2015030201.18},
  abstract = {Aim: We aimed to assess the aesthetic outcome of surgical reconstruction by free ALT flap using binocular single-refraction magnifying glasses and a modified post- operative surveillance protocol.Methods: 16 patients were operated for free antero-lateral thigh flap to reconstruct complex soft tissue defects with a close clinical follow up protocol for post operative care depending on the attending personnel in the Plastic surgery unit, Suez Canal University hospital, Ismailia, Egypt. Aesthetic outcome was assessed using a questionnaire based on Posch et al. 2005, including the following itemscolour, contour, presence of hair, overall appearance and donor site scar.Results:The patients’ assessed aesthetic outcome was acceptable in majority of the cases; median score was 4 for all assessed items. Complete flap loss occurred in one case, other complications as arterial thrombosis and hematomas and infection were detected and managed accordingly with flap salvage in the 3 complicated cases.Conclusion:The result suggests that the proposed protocol is sufficient as an alternative. The aesthetic outcome assessed by the patient and the failure rate was in line with other studies.},
 year = {2015}
}

Copy | Download

TY  - JOUR
T1  - Aesthetic Outcome After Reconstruction of Complex Soft Tissue Defects with Free Antero-Lateral Thigh Flap Using Simple Equipment
AU  - Ashraf H. Abbas
AU  - Moustafa Elmasry
AU  - Ingrid Steinvall
AU  - Osama A. Adly
AU  - Mohamed A. Elbadawy
AU  - Taha Ali Moati
AU  - Folke Sjöberg
Y1  - 2015/05/09
PY  - 2015
N1  - https://doi.org/10.11648/j.js.s.2015030201.18
DO  - 10.11648/j.js.s.2015030201.18
T2  - Journal of Surgery
JF  - Journal of Surgery
JO  - Journal of Surgery
SP  - 36
EP  - 41
PB  - Science Publishing Group
SN  - 2330-0930
UR  - https://doi.org/10.11648/j.js.s.2015030201.18
AB  - Aim: We aimed to assess the aesthetic outcome of surgical reconstruction by free ALT flap using binocular single-refraction magnifying glasses and a modified post- operative surveillance protocol.Methods: 16 patients were operated for free antero-lateral thigh flap to reconstruct complex soft tissue defects with a close clinical follow up protocol for post operative care depending on the attending personnel in the Plastic surgery unit, Suez Canal University hospital, Ismailia, Egypt. Aesthetic outcome was assessed using a questionnaire based on Posch et al. 2005, including the following itemscolour, contour, presence of hair, overall appearance and donor site scar.Results:The patients’ assessed aesthetic outcome was acceptable in majority of the cases; median score was 4 for all assessed items. Complete flap loss occurred in one case, other complications as arterial thrombosis and hematomas and infection were detected and managed accordingly with flap salvage in the 3 complicated cases.Conclusion:The result suggests that the proposed protocol is sufficient as an alternative. The aesthetic outcome assessed by the patient and the failure rate was in line with other studies.
VL  - 3
IS  - 2-1
ER  -

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