Abstract

The anterolateral thigh flap(ALT flap) was originally described in 1984 as a septocutaneous flap based on the descending branch of the lateral circumflex artery. This flap has some significant advantages for reconstruction of the head and neck. It can be raised as a subcutaneous flap, a fasciocutaneous flap, or a myocutaneous flap and can resurface large defects in the head and neck. In addition, it has a large and long vascular pedicle, and because of the distance of the donor site from the head and neck, it can easily be harvested with a two-team approach. However, the number and locations of cutaneous perforators vary individually, and thus, it is not widely used because flap elevation is often complicated and time-consuming owing to unexpected anatomical variations. The purposes of this study are to clarify the vascular anatomy and to assess the suitability of anterolateral thigh flap for oral cavity reconstruction in Koreans. In addition, we used anterolateral thigh free flap for oral cavity reconstruction in 20 oral cancer patients from 2006 to 2011. Through our clinical experience, we discuss a series of practical “pearls and pitfalls”. Our experience has not only given us new flap choice using anterolateral thigh flap in oral cavity reconstruction, but also given us a new possibility on the applicability of chimeric flaps.