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Sandwich Fascial Anterolateral Thigh Flap in Head and Neck Reconstruction: Evolution or Revolution?
INTRODUCTION: The anterolateral thigh perforator flap (ALT) represents the workhorse for most reconstructive efforts in the head and neck regions. The main advantages of this flap are its versatility, the length of the pedicle, and the low morbidity of the donor site. The major drawback is the bulki...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Wolters Kluwer Health
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5293297/ https://www.ncbi.nlm.nih.gov/pubmed/28203499 http://dx.doi.org/10.1097/GOX.0000000000001197 |
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author | Cherubino, Mario Berli, Jens Turri-Zanoni, Mario Battaglia, Paolo Maggiulli, Francesca Corno, Martina Tamborini, Federico Montrasio, Edoardo Castelnuovo, Paolo Valdatta, Luigi |
author_facet | Cherubino, Mario Berli, Jens Turri-Zanoni, Mario Battaglia, Paolo Maggiulli, Francesca Corno, Martina Tamborini, Federico Montrasio, Edoardo Castelnuovo, Paolo Valdatta, Luigi |
author_sort | Cherubino, Mario |
collection | PubMed |
description | INTRODUCTION: The anterolateral thigh perforator flap (ALT) represents the workhorse for most reconstructive efforts in the head and neck regions. The main advantages of this flap are its versatility, the length of the pedicle, and the low morbidity of the donor site. The major drawback is the bulkiness of this flap with the frequent need for secondary revisions. To overcome this, we have developed a novel way to harvest and inset the ALT, called the sandwich fascial ALT flap (SALT). METHODS: All patients undergoing head and neck reconstruction using the SALT flap from January 2013 to March 2016 were included in this retrospective analysis. The SALT flap was harvested as a composite flap including the superficial fascia, the subscarpal fat, and the deep fascia. At the recipient site, the flap was inset with the deep fascia facing out. A split thickness skin graft (± dermal substitute) was used to cover the deep fascia and the pedicle. RESULTS: Eleven patients were included: 8 cases of orbital exenteration, 1 case of forehead reconstruction, and 2 cases of palatal reconstruction after radical maxillectomy. Flap survival was 100%. One patient required an early take back for venous thrombosis. The reconstruction was effective in all cases, allowing a prosthetic rehabilitation when required. Donor-site morbidity was minimal. CONCLUSIONS: The reconstruction of head and neck defects with a bulky fasciocutaneous ALT flap might not be the best option in every case. The SALT flap could represent a valid alternative for selected cases, with encouraging functional and cosmetic outcomes. |
format | Online Article Text |
id | pubmed-5293297 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Wolters Kluwer Health |
record_format | MEDLINE/PubMed |
spelling | pubmed-52932972017-02-15 Sandwich Fascial Anterolateral Thigh Flap in Head and Neck Reconstruction: Evolution or Revolution? Cherubino, Mario Berli, Jens Turri-Zanoni, Mario Battaglia, Paolo Maggiulli, Francesca Corno, Martina Tamborini, Federico Montrasio, Edoardo Castelnuovo, Paolo Valdatta, Luigi Plast Reconstr Surg Glob Open Original Article INTRODUCTION: The anterolateral thigh perforator flap (ALT) represents the workhorse for most reconstructive efforts in the head and neck regions. The main advantages of this flap are its versatility, the length of the pedicle, and the low morbidity of the donor site. The major drawback is the bulkiness of this flap with the frequent need for secondary revisions. To overcome this, we have developed a novel way to harvest and inset the ALT, called the sandwich fascial ALT flap (SALT). METHODS: All patients undergoing head and neck reconstruction using the SALT flap from January 2013 to March 2016 were included in this retrospective analysis. The SALT flap was harvested as a composite flap including the superficial fascia, the subscarpal fat, and the deep fascia. At the recipient site, the flap was inset with the deep fascia facing out. A split thickness skin graft (± dermal substitute) was used to cover the deep fascia and the pedicle. RESULTS: Eleven patients were included: 8 cases of orbital exenteration, 1 case of forehead reconstruction, and 2 cases of palatal reconstruction after radical maxillectomy. Flap survival was 100%. One patient required an early take back for venous thrombosis. The reconstruction was effective in all cases, allowing a prosthetic rehabilitation when required. Donor-site morbidity was minimal. CONCLUSIONS: The reconstruction of head and neck defects with a bulky fasciocutaneous ALT flap might not be the best option in every case. The SALT flap could represent a valid alternative for selected cases, with encouraging functional and cosmetic outcomes. Wolters Kluwer Health 2017-01-17 /pmc/articles/PMC5293297/ /pubmed/28203499 http://dx.doi.org/10.1097/GOX.0000000000001197 Text en Copyright © 2017 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of The American Society of Plastic Surgeons. All rights reserved. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND) (http://creativecommons.org/licenses/by-nc-nd/4.0/) , where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. |
spellingShingle | Original Article Cherubino, Mario Berli, Jens Turri-Zanoni, Mario Battaglia, Paolo Maggiulli, Francesca Corno, Martina Tamborini, Federico Montrasio, Edoardo Castelnuovo, Paolo Valdatta, Luigi Sandwich Fascial Anterolateral Thigh Flap in Head and Neck Reconstruction: Evolution or Revolution? |
title | Sandwich Fascial Anterolateral Thigh Flap in Head and Neck Reconstruction: Evolution or Revolution? |
title_full | Sandwich Fascial Anterolateral Thigh Flap in Head and Neck Reconstruction: Evolution or Revolution? |
title_fullStr | Sandwich Fascial Anterolateral Thigh Flap in Head and Neck Reconstruction: Evolution or Revolution? |
title_full_unstemmed | Sandwich Fascial Anterolateral Thigh Flap in Head and Neck Reconstruction: Evolution or Revolution? |
title_short | Sandwich Fascial Anterolateral Thigh Flap in Head and Neck Reconstruction: Evolution or Revolution? |
title_sort | sandwich fascial anterolateral thigh flap in head and neck reconstruction: evolution or revolution? |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5293297/ https://www.ncbi.nlm.nih.gov/pubmed/28203499 http://dx.doi.org/10.1097/GOX.0000000000001197 |
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