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ALT Flap (alt + flap)

Distribution by Scientific Domains

Medical Sciences	100%

Selected Abstracts

Functional reconstruction of complex lip and cheek defect with free composite anterolateral thigh flap and vascularized fascia,

HEAD & NECK: JOURNAL FOR THE SCIENCES & SPECIALTIES OF THE HEAD AND NECK, Issue 8 2008
Yur-Ren Kuo MD
Abstract Background. Extensive composite defects involving the lip and cheek present difficult reconstructive challenges. This study presents a technique using anterolateral thigh (ALT) flaps with vascularized fascia for large complex oral sphincter defect reconstruction. Methods. Fifteen patients who had undergone oral cancer ablation were enrolled in the study. The average area of intraoral lining and cheek,lip skin defects was 96.9 cm2. Upper-lip defects ranged 0% to 60%, and lower-lip defects ranged 20% to 80%. Skin and intraoral lining defects were replaced by an ALT fasciacutaneous flap. The vascularized fascia of the flap was used to provide lip suspension. Results. Flap survival was 100%. All but 1 patient had good static suspension. Nine patients had adequate oral competence without drooling, but 6 had occasional oral incontinence. All patients achieved an acceptable appearance. Conclusions. For extensive cheek,lip composite defects, ALT flap together with vascularized fascia has proven to be a useful option for functional reconstruction. © 2008 Wiley Periodicals, Inc. Head Neck 2008 [source]

Functional Outcomes after Circumferential Pharyngoesophageal Reconstruction

THE LARYNGOSCOPE, Issue 7 2005
Jan S. Lewin PhD
Abstract Objective: To determine functional speech and swallowing outcomes, morbidity, and complication rates after reconstruction of circumferential pharyngoesophageal defects using a jejunal versus an anterolateral thigh (ALT) flap. Study Design: Retrospective analysis. Methods: We reviewed the medical records of 58 patients with circumferential pharyngoesophageal defects, 27 with ALT flap reconstruction, and 31 with jejunal interposition. We compared complication rates, intensive care unit (ICU) and hospital stays, nutritional intake, number of tracheoesophageal punctures (TEPs) performed, TE speech fluency, and functional use. Modified barium swallow studies assessed swallowing physiology. Results: Patient characteristics were similar. Total flap loss occurred in one (3.7%) patient with an ALT flap and two (6.5%) patients with jejunal interposition (P = 1.000), fistula in two (7.4%) ALT patients and one (3.2%) jejunal patient (P = .5931), and anastomotic stricture in four (15%) ALT patients and six (19.4%) jejunal patients (P = .7371). ICU and hospital stays were greater for jejunal patients (P = .001, <.001, respectively). TEPs were performed in eight jejunal patients and nine ALT patients. Eighty-nine percent of ALT patients and 63% of jejunal patients were fluent, whereas 78% of ALT patients and 25% of jejunal patients used TE speech to communicate. Ninety-one percent of ALT patients and 73% of jejunal patients resumed oral intake (P = .151). The most common causes of dysphagia were impaired tongue base retraction (62% jejunum) and disordered motility (62% jejunum, 67% ALT). Conclusions: For circumferential pharyngoesophageal reconstruction, the ALT flap results in similar complication rates, but shorter ICU and hospital stays, and better speech and swallowing compared with jejunal reconstruction. [source]

Customized reconstruction with the free anterolateral thigh perforator flap

MICROSURGERY, Issue 7 2008
Holger Engel M.D.
From April of 2003 through September of 2006, 70 free anterolateral thigh (ALT) flaps were transferred for reconstructing soft-tissue defects. The overall success rate was 96%. Among 70 free ALT flaps, 11 were elevated as cutaneous ALT septocutaneous vessel flaps. Fifty-seven were harvested as cutaneous ALT myocutaneous "true" perforator flaps. Two flaps were used as fasciocutaneous perforator flaps based on independent skin vessels. Fifty-four ALT flaps were used for lower extremity reconstruction, 11 flaps were used for upper extremity reconstruction, 3 flaps were used for trunk reconstruction, and 1 flap was used for head and neck reconstruction. Total flap failure occurred in 3 patients (4.28% of the flaps), and partial failure occurred in 5 patients (7.14% of the flaps). The three flaps that failed completely were reconstructed with a free radial forearm flap, a latissimus dorsi flap and skin grafting, respectively. Among the five flaps that failed partially, three were reconstructed with skin grafting, one with a sural flap, and one with primary closure. The free ALT flap has become the workhorse for covering defects in most clinical situations in our center. It is a reliable flap with consistent anatomy and a long, constant pedicle diameter. Its versatility, in which thickness and volume can be adjusted, leads to a perfect match for customized reconstruction of complex defects. © 2008 Wiley-Liss, Inc. Microsurgery, 2008. [source]