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European Journal of Plastic Surgery

, Volume 41, Issue 2, pp 253–254 | Cite as

Technical tip for direct closure of donor site of anterolateral thigh rectangular flaps wider than 9 cm used for pharyngo-esophageal reconstruction

  • Luis Miranda-Gómez
  • Alberto Pérez-García
  • Eduardo Simón-Sanz
  • María Eloísa Villaverde-Doménech
  • Juan Ramón Esteban-Vico
  • Cristhian Steve Klenner-Muñoz
Short Communication

Anterolateral thigh (ALT) flap has become the workhorse flap for total pharyngo-esophageal reconstruction. In order to achieve a tube of at least 3 cm diameter, a flap of at least 9.4 cm width is required. It is usually accepted that primary closure of the donor area is not possible when flap width is over 8–9 cm and when flap width-to-thigh circumference ratio is over 16%, this condition being influenced by the body mass index (BMI) and the age of the patient. Another factor reported to be involved in the amount for primary closure is the thickness of the subcutaneous adipose tissue of the thigh and its muscular tissue, both of them also in relation with the BMI and the age [1, 2, 3]. When the primary closure is not possible, skin grafting is usually chosen to complete the closure.

We are writing to describe a technical tip which allows direct closure of defects over 9 cm width, with a flap width-to-thigh circumference ratio over 16% in patients with diverse BMI. After harvest, the...

Notes

Compliance with Ethical Standards

Funding

Each author separately declares to have no subvention with any organisms.

Conflicts of interest

Luis Miranda-Gómez, Alberto Pérez-García, Eduardo Simón-Sanz, María Eloísa Villaverde-Doménech, Juan Ramón Esteban-Vico, and Cristhian Steve Klenner-Muñoz declare that they have no conflict of interest.

Ethical approval

For this type of study ethical approval is not required.

Informed consent

Written patient consent was obtained prior to surgery and includes inclusion for educational purposes as affiliated with the University Hospital.

References

  1. 1.
    Boca R, Kuo YR, Hsieh CH, Huang EY, Jeng SF (2010) A reliable parameter for primary closure of the free anterolateral thigh flap donor site. Plast Reconstr Surg 126:1558–1562CrossRefPubMedGoogle Scholar
  2. 2.
    Song K, Nam S, Choi S, Kim J, Lee J, Bae Y (2013) Objective preoperative estimation of the ability of primary closure on anterolateral thigh free flap donor site: circumference and area ratios of deep tissue to thigh. Microsurgery 33:270–274CrossRefPubMedGoogle Scholar
  3. 3.
    Visconti G, Salgarello M (2013) Anteromedial thigh perforator-assisted closure of the anterolateral thigh free flap donor site. J Plast Reconstr Aesthet Surg 66:e189–e192CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany 2017

Authors and Affiliations

  • Luis Miranda-Gómez
    • 1
  • Alberto Pérez-García
    • 1
  • Eduardo Simón-Sanz
    • 1
  • María Eloísa Villaverde-Doménech
    • 1
  • Juan Ramón Esteban-Vico
    • 1
  • Cristhian Steve Klenner-Muñoz
    • 1
  1. 1.Department of Plastic Surgery and BurnsHospital Universitari i Politècnic La FeValenciaSpain

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