European Journal of Plastic Surgery

, Volume 36, Issue 11, pp 731–732 | Cite as

Florid hyperaemia arising in ALT free flaps harvested from old skin graft donor sites

  • Kieran T. Power
  • Banan OsmanEmail author
  • Kelvin Ramsey
Letter to the Editor


We would like to highlight two cases of localized hyperaemia arising in antero-lateral thigh (ALT) free flaps harvested from previously healed split thickness skin graft donor sites. The vascular changes led to concerns about possible flap perfusion compromise, with the increasing popularity of the ALT free flap, we thought it's important to document this phenomenon and suggest possible aetiology.

A 52-year-old gentleman presented for management of recurrent Merkel cell carcinoma arising from his left calf. After an extensive resection, a free ALT flap was used to reconstruct the defect. The flap was based on two septocutaneous perforators, and the skin paddle was harvested from a part of a thigh which incorporated a 6-month-old healed skin graft donor site. There was no obvious discoloration of the donor site prior to raising the flap.

On the first post-operative day, the flap developed an area of florid hyperaemia with epidermolysis corresponding exactly to the site of the...


Free Flap Merkel Cell Carcinoma Split Thickness Skin Graft Perforator Flap Free Tissue Transfer 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Conflict of Interest



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Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  1. 1.Royal Marsden NHS trustLondonUK

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