Pedicled Anterolateral Thigh Flap Coverage of Traumatic Abdominal Wound: A Case Report

Abstract

Pedicled anterolateral thigh (ALT) flap has been employed for coverage of low abdominal wall defects. However, its use is limited for defects located more on the cranial side because of insufficient pedicle length.

Here,we present a case of successful reconstruction of mid-abdominal wall defect using pedicled ALT flap. A 15 year old boy suffered from 22×15 cm full thickness soft tissue defect with exposed gut caused by road traffic accident. A pedicled ALT flap was planned for the defect coverage. After we performed debridement to prepare the wound bed, a 19 × 15 cm sized ALT flap based on two lateral circumflex femoral artery (LCFA) perforators was elevated. During intramuscular dissection of perforators, we dissected the distal portion of the LCFA descending branch.We passed the flap through a subcutaneous tunnel and conducted smooth flap insetting without any tension on the lengthened pedicle.Postoperatively,there was marginal necrosis possibly due to a large dimension of flap followed by  two episodes of wound dehiscence. The patient was discharged on 75 days after admission with fracture Right shaft of  femur  healed conservatively. A local ALT flap with pedicle lengthened might be a reliable option for reconstruction of supraumbilical abdominal defects.³