360° of Freedom in Chimeric Pedicled Vastus Lateralis-ALT Perforator Flap for Reconstruction in Patients with Advanced or Recurrent Malignancies

Kosutic D, Mulh R, Apostolos V and Solinc M

Department of Plastic and Reconstructive Surgery, Christie NHS Foundation Trust, Manchester, UK
Department of Plastic and Reconstructive Surgery, Clinical Centre Ljubljana, Slovenia

^*Correspondance to: Damir Kosutic 

 PDF  Full Text DOI: 10.25107/2474-1647.1401

Abstract

Introduction: Defects following resections of advanced malignancies and particularly sarcomas are often challenging from functional and reconstructive point of view. In recent years, a chimeric vastus-lateralis-fascio-cutanoues ALT was described, allowing greater versatility and more sophisticated reconstructions. We report our experience with pedicled chimeric vastus-lateralis muscle-facioucutanous ALT pedicled flap for reconstruction following resection of sarcomas and advanced melanomas or complications of sarcoma resections in a large tertiary cancer centre with the longest ever follow up published so far.Methods: From 2009 to 2016, 29 pedicled perforator chimeric vastuslateralis muscle-fascioucutaneous ALT flaps were used to reconstruct defects following primary and recurrent sarcomas and advanced melanomas in 29 patients. Data on tumor type, defect and vascular anatomy, number of perforators used for the flap, arc of rotation, comorbidities, complications, donor site morbidity and long term outcomes were collected prospectively and analyzed.Results: Defects involved pubic and suprapubic areas, lower abdomen, vulvar region, peritrochanteric area, groin, supra-patellar, upper and lower thigh and lateral aspect of knee joint. All 29 flaps completely survived in all patients. All donor sites healed primarily. There were no local recurrences. Patients (7) developed metastasis within 2 years from resection and reconstruction and all of them were dead within 1 year from the date metastatic spread was diagnosed. Remaining patients on long-term follow up continue to have excellent functional and aesthetic outcome.Conclusion: We suggest pedicled chimeric vastuslateralis-ALT flap as an excellent option for reconstruction of defects following removal of advanced or recurrent malignancies in elderly patients.

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Cite the article

Kosutic D, Mulh R, Apostolos V, Solinc M. 360° of Freedom in Chimeric Pedicled Vastus Lateralis-ALT Perforator Flap for Reconstruction in Patients with Advanced or Recurrent Malignancies. Clin Surg. 2017; 2: 1401.