Anterolateral Thigh Perforator Free Flap

This chapter deals with a method of reconstructing soft tissue defects to various regions of the body. The anterior lateral thigh (ALT) perforator free flap has the ability to provide either individual components or any combination of skin, fascia, and muscle to reconstruct soft tissue defects of the head and neck region. ALT free flap harvest is contraindicated in patients who have had previous vascular bypass procedures in the lower extremities. Due to the variable nature of the ALT skin perforators, patients should be consented for modification of the flap design and for flap harvest from the contralateral thigh. Postoperatively, the patient is typically kept intubated and transferred to the intensive care unit (ICU) for monitoring of the flap. Feeds via nasogastric, orogastric, gastrostomy, or jejunostomy tube are initiated 36-48 hours postoperatively.