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15 December 2018 : Clinical Research  

Alternative Design for Anterolateral Thigh Multi-Paddled Flaps: The 3-5 System

Chengliang Deng1ACEF, Shusen Chang1BDE, Zairong Wei1ADFG*, Wenhu Jin1ACE, Hai Li1BDE, Kaiyu Nie1BF, Xiujun Tang1AE, Dali Wang1CD

DOI: 10.12659/MSM.911883

Med Sci Monit 2018; 24: CLR9102-9109

Abstract

BACKGROUND: The design and harvest of the anterolateral thigh (ALT) multi-paddled flap is a critical step in reconstructive surgeries. However, limited perforator distribution patterns of traditional design methods have gradually emerged in clinical practice. The aim of this study was to investigate the effect of a new technique (the 3-5 system) on ALT multi-paddled flap design.

MATERIAL AND METHODS: A total of 151 ALT flaps were harvested from 149 patients over a 26-month period. Among them, 100 ALT flaps were examined preoperatively using a handheld Doppler device to localize vascular perforators.

RESULTS: By detecting perforator penetration points through the vastus lateral muscle (VLM) or the intermuscular septum and perforator entry points to the deep fascia, precise ALT flap perforator distribution patterns were found. Meanwhile, a 3-5 system was developed to design ALT flaps based on these findings. The remaining 51 ALT flaps from 49 patients during a 9-month period did not require the use of preoperative handheld Doppler. In addition, preoperative handheld Doppler and intraoperative findings demonstrated that all ALT flap penetration points through the VLM or intermuscular septum and the perforator entry point in the deep fascia were closely related based on 3 longitudinal lines and 5 horizontal lines.

CONCLUSIONS: ALT flaps were successfully harvested using a 3-5 system without the need for preoperative handheld Doppler analysis. Moreover, the 3-5 system is a simple and practical approach for preoperative ALT multi-paddled flap design.

Keywords: Doppler Effect, Research Design, Surgical Flaps

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Medical Science Monitor eISSN: 1643-3750
Medical Science Monitor eISSN: 1643-3750