股前外侧皮瓣(ALTP)

lateral circumflex femoral artery flaps: Anatomical description and clinical implications
Department of Burn and Plastic Surgery, Affiliated Hospital of Zunyi Medical College
Advantage




Concealed donor site, without sacrifice of major limb vascular, large area, can carry sensory nerve, for small, the function and appearance of the area, medium and small flap without skin grafting, the patient received good. Vascular pedicle length, diameter, not only can be free of transplantation, but also with vascular pedicle transposition； Less vascular variation, simple operation, high success rate； Operation position is good, for, the district can be carried out at the same time, save the operation time。 Because of the skin flap with vascular pedicle length, diameter, limb of the non main vessel, vascular variation is small, simple operation, no need to change the position, cutting take large area, hidden parts, sensory nerve and skin flap cut for the affected area function after taking can made with the sensation of the flaps and fascia flap, muscle flap advantages.
Shun-Hong Gao, Shi-Ming Feng, Chao Chen, M.D., A New Recipient Artery for Reconstruction of SoftTissue Defects in the Lower Limb with a Free Anterolateral Thigh Flap: The Reversed Descending Branch of the Lateral Femoral Circumflex Artery. Plastic and Reconstructivelood supply types

There are three types of skin in the upper part of the femoral artery: There were 18 sides (36) in the main type of the descending artery. On the 50 sides of the 6 sides of the uniform distribution (12) There were 5 (10) of the main types of the high cutaneous artery in the 50 side.
1.
Shun-Hong Gao, Shi-Ming Feng, Chao Chen, M.D., A New Recipient Artery for Reconstruction of Soft-Tissue Defects in the Lower Limb with a Free Anterolateral Thigh Flap: The Reversed Descending Branch of the Lateral Femoral Circumflex Artery. Plastic and Reconstructive Surgery,2012,11:1059-1065
Disadvantages
（1）Cyclophos phamide circumflex femoral descending branch of the lateral musculocutaneous perforator anatomy variation, sometimes in order to determine the flap blood supply and demand for a long time; （2) by district need to sacrifice a major artery; （3)flap is relatively overstaffed and need second operation of plastic repair; (4) flap in nerve docking is required to have sensory nerve implantation to resume the sensation of the flaps to obtain satisfactory curative effect.
Content

History and development
Anatomy


Clinical application
Merits


Disadvantages
History and Development
1983 Xu,First discovery 1984 Luo, first applied Popularization and Application in China，Japan， U.S.A，Turkey,et al
1993，Koshima et al.ALTPF clinical implication （First report）.
Anatomic basis

Vascular pedicle: descending branch of the lateral femoral artery; Pedicle length 8~12cm, diameter of the artery was 2.1 + 0.1mm, and the diameter of the two lines was slightly rough; The musculocutaneous perforator artery 59.8, intermuscular cutaneous 40.2; Cutaneous artery diameter of 0.6 + 0.02 (0.4~1.1) mm, the blood supply area: latex specimens of 12cm * 30cm, 12.5 * 38cm ink samples; Distribution of lateral cutaneous nerve.


From Clinical Anatomic Atlas of Microsurgery
From Clinical Anatomic Atlas of Microsurgery
From Clinical Anatomic Atlas of Microsurgery
CCASE
1.
Clinical application progress

Four kinds of repair operation The reconstruction of vagina, buttocks and lower abdomen wall; Retrograde transposition: repair of knee joint and lower leg tissues; Free transplantation: extensive application in the repair and reconstruction of head and neck, trunk and limbs; Combined skin flap: a period of repair of large area of the body tissue defect, reconstruction of limb function and shape.