Versatility of the Pedicled ALT Flap in Defect Reconstruction: Experience of a Unit in Rural Sub-Saharan African

Abstract

Background: The free anterolateral thigh flap with its large caliber vessels, a reliable skin territory and minimal donor site morbidity is the reconstructive surgeons’ workhorse. The pedicled flap though not as popular, has been used extensively for the reconstruction of defects from the mid-leg to the epigastrium. The favorable profile of the anterolateral thigh flap, with minimal variability of its vascular anatomy and donor site complications is well described in most races; literature of its use in sub-Saharan Africa is scanty.
Methods: The author describes the use of the anterolateral thigh flap in a series of 17 patients in a rural African hospital, illustrating its versatility as well as the complications associated with its use in this patient population.
Results: Seventeen patients withtwenty antero-lateral thigh flaps were followed for an average of 24 months.
Conclusions: The pedicled antero-lateral thigh flap is an excellent reconstructive tool with very good results in the black African population. This versatile flap has low donor site morbidity. The risk of developing hypertrophic scars and keloids remains a real concern in Black patients and longer term follow-up and a larger number of patients are needed to establish this potential complication.

Key words: Anterolateral thigh flap, Africa