Anatomical Variations of Anterolateral Thigh Flap: A Fresh Cadaver Dissection Study

The anterolateral thigh (ALT) flap is one of the fasciocutaneous flaps in the thigh region based on the septocutaneous or musculocutaneous perforators derived from the lateral circumflex femoral artery (LCFA). This cadaveric study aimed to explore the variability of ALT flap anatomy.

Ten ALT flaps were dissected (2016-20117, Mashhad Legal Medicine Organization) in 10 fresh cadavers (7 males and 3 females). Flaps were marked in a 15 cm area centered on the middle point of a line drown from anterior superior iliac spine to the lateral surface of the patella. Dissection began by searching the skin perforators and then continued along the pathway of the vascular pedicle.

The average distance of ASIS-Patella was 44.6 cm. The mean number of skin perforators was 2.4 (ranged from 0 to 4). In one case, we did not find any skin perforator. The majority of skin perforators were musculocutaneous from descending branch of LCFA (66.7%) and the remaining were septocutaneous (33.3%). The mean length of vascular pedicle was 10.17 cm. The average diameter of vascular pedicle was 2.78 mm for the artery and 3.79 mm for the vein. The average time of flap harvesting was 85.3 min (ranged from 50 to 125 min).

The skin perforators supplying the ALT flap showed significant variability in number, location and course. The cadaveric study could enhance the anatomic knowledge and operative skills of ALT flap harvesting.