Reconstruction of large through-and-through abdominal wall defects using anterolateral thigh flaps

Five large through-and-through abdominal wall post tumor ablation defects were successfully reconstructed using anterolateral thigh flaps. A pedicled anterolateral thigh flap and a super-charged anterolateral flap with double vascular pedicles were used for one case each, and a free anterolateral thigh flap was used in three cases. Anterolateral thigh flaps provide large skin territories, sturdy fascia and long vascular pedicles without sacrificing main vessels and muscles. Therefore, lower abdominal wall defects can easily be covered by pedicled anterolateral thigh flaps. When a longer vascular pedicle based on a distal perforator is unavailable, a pedicled anterolateral thigh flap can be transferred to the epigastrium. When an anterolateral thigh flap is supplied by double perforators derived from separate branches of the lateral circumflex femoral system, a Siamese flap can also be elevated. The authors consider the anterolateral thigh flap to be a favorable alternative to conventional free flaps and the pedicled tensor fascia lata myocutaneous flap.