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Feasibility of pedicled anterolateral thigh flap with tensor fascia lata and vastus lateralis for difficult abdominal wall closure

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Abstract

Purpose

Long-term follow-up for pedicled anterolateral thigh (ALT) flap with vastus lateralis and tensor fascia lata for complex abdominal wall reconstruction is rarely reported. This study aimed to evaluate the feasibility of extended pedicled ALT flap.

Methods

This retrospective review was conducted at a single medical center between 2011 and 2018. A total of 35 patients with complex abdominal wall defects reconstructed with partition (n = 20) or pedicled ALT flap (n = 15) were enrolled. Data on gender, age, fascial defect size, operation time, hospital days, follow-up duration, and complications were obtained. Mann–Whitney test evaluated the differences in continuous data, and Chi-square test analyzed categorical data.

Results

The partition technique was associated with 10.15 cm (range 8–14 cm) mean defect size, 146 min average operation time, 13.5 hospital days, and 95.42 months of mean follow-up duration. Short- and long-term complications were observed in seven (35%) and six (30%) cases, respectively. The pedicled ALT flap technique was associated with 13.4 cm (range 10.6–16 cm), 342.86 min average operation time, 22.33 hospital days, and 69.4 months of mean follow-up duration. Short- and long-term complications were observed in six (40%) and five (33%) cases, respectively. Significant differences in defect size, operative time, hospital days, and donor-site skin graft loss (p < 0.05) were observed between the groups.

Conclusions

Extended pedicled ALT flap is a reliable option for complex abdominal wall reconstruction. Compared with the partition technique group, the extended pedicled ALT group had closure of larger fascia defects. However, it was associated with a higher risk of donor-site skin graft loss and longer operative time and hospital days.

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Authors and Affiliations

  1. Department of Plastic and Reconstructive Surgery, China Medical University Hospital, 2 Yuh Der Road, 404, Taichung City, Taiwan, Republic of China

    P.-K. Shih

  2. China Medical University, Taichung, Taiwan, Republic of China

    P.-K. Shih

  3. Department of Cosmetics and Health Care, Chung-Jen Junior College of Nursing, Health Sciences and Management, Chiayi City, Taiwan, Republic of China

    P.-K. Shih

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  1. P.-K. Shih
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Correspondence to P.-K. Shih.

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Conflict of interest

PKS (Pin-Keng Shih) declares no conflict of interest.

Ethical approval

This study was approved by the ethical committee of China Medical University.

Human and animal rights

The study including human participants has been performed in accordance with the ethical standards of the Declaration of Helsinki and its later amendments.

Informed consent

All patients provided written informed consent.

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Shih, PK. Feasibility of pedicled anterolateral thigh flap with tensor fascia lata and vastus lateralis for difficult abdominal wall closure. Hernia 23, 749–755 (2019). https://doi.org/10.1007/s10029-018-1859-0

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