Short- and Long-Term Complications of Free Anterolateral Thigh Flap Reconstructions: A Single-Centre Experience of 92 Consecutive Cases

Table 2

Aetiologies, complications, and management strategies for free ALT flap transfer.

No.	Defect aetiology	Body part	Perforator type	Donor area closure	Complication	Interval from flap harvesting	Management
1	BCC excision nasolabial fold with partial maxillectomy	Face	Descending branch of circumflex artery	Direct	Excess tissue	1 year 8 months	Debulking
2	Sarcoma	Face		Direct	Asymmetry and excess bulk	11 months	Coleman fat transfer and liposuction/debulking
3	Sarcoma	Forearm		SSG	Excess bulk	2 years 4 months	Liposuction and debulking
4	Infected tibial implant	Lower leg/ankle	Lateral femoral circumflex artery	Direct	Excess bulk	1 year 8 months	Liposuction and debulking
5	Sarcoma	Lower leg/ankle		Direct	Excess bulk	2 years 3 months	Liposuction and debulking
6	Sarcoma	Medial malleolus	Lateral femoral circumflex artery	Direct	Excess bulk	1 year 2 months	Liposuction and debulking
7	Chronic wound	Ankle	Lateral femoral circumflex artery	Direct	Excess bulk and tight fascia in superior and inferior areas	2 years 4 months	Liposuction and debulking, fasciotomy
8	Open fractures	Foot		SSG	Excess bulk	1 year 2 months 3 years 5 months	Liposuction and debulking on both occasions
9	Sarcoma	Foot	Lateral femoral circumflex artery	Direct	Excess bulk excess bulk and hyperextension at 5^th MTPJ	8 months 1 year 2 months	Liposuction and debulking on both occasions of tenolysis at second revision
10	Exposed TKR	Knee		Direct	Venous thrombosis and small are of flap necrosis	3 days	Debridement of non-viable tissue and coverage with vacuum dressing
11	Incisional hernia	Lower abdomen		Direct	Venous thrombosis, flap ischaemia	1 day	Flap lifted from fascia and fascia used as a nonvascularized graft
12	Sarcoma	Thigh		Direct	Venous thrombosis and flap failure	4 days	Application of meshed SSG
13	Sarcoma	Knee		Direct	Minimal venous thrombosis	1 day	Re-look at pedicle
14	Sarcoma	Lower leg/ankle		Direct	Venous thrombosis and flap failure	2 days	Medial gastrocnemius muscle flap
15	Burn scar contracture with cellulitis	Ankle	Lateral femoral circumflex artery	Direct	Small area of devitalised skin	1 week	Resection of devitalised skin and re-suture
16	Sarcoma	Knee		Direct	Retained drain tip	4 days	Removal of retained drain tip in theatre

Abbreviations: SSG, split-thickness skin graft; MTPJ, metatarsophalangeal joint; TKR, total knee replacement.