The anterolateral thigh flap was widely used in plastic surgery as a perforator flap based on the vessels from the descending branch of the lateral femoral circumflex artery. However, the broad range of anatomic variation of the perforators is a mainly disavantage of this flap. Perforator anatomy and their direction to the anterolateral thigh flap were examined in 60 specimens of 30 Vietnamese cadavers and in 74 anterolateral thigh flaps of 68 patients. The direction of perforator in muscle and the angle between perforator and deep fascial layer at percing point was analyzed. The findings in this study suggest that the design of the anterolateral thigh flap should be based on the angle of perforator into the deep fascia. Forth dimention of the flap was considerably based on flow direction of perforator.
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