Technical tip for direct closure of donor site of anterolateral thigh rectangular flaps wider than 9 cm used for pharyngo-esophageal reconstruction
Anterolateral thigh (ALT) flap has become the workhorse flap for total pharyngo-esophageal reconstruction. In order to achieve a tube of at least 3 cm diameter, a flap of at least 9.4 cm width is required. It is usually accepted that primary closure of the donor area is not possible when flap width is over 8–9 cm and when flap width-to-thigh circumference ratio is over 16%, this condition being influenced by the body mass index (BMI) and the age of the patient. Another factor reported to be involved in the amount for primary closure is the thickness of the subcutaneous adipose tissue of the thigh and its muscular tissue, both of them also in relation with the BMI and the age [1, 2, 3]. When the primary closure is not possible, skin grafting is usually chosen to complete the closure.
Compliance with Ethical Standards
Each author separately declares to have no subvention with any organisms.
Conflicts of interest
Luis Miranda-Gómez, Alberto Pérez-García, Eduardo Simón-Sanz, María Eloísa Villaverde-Doménech, Juan Ramón Esteban-Vico, and Cristhian Steve Klenner-Muñoz declare that they have no conflict of interest.
For this type of study ethical approval is not required.
Written patient consent was obtained prior to surgery and includes inclusion for educational purposes as affiliated with the University Hospital.