To investigate the feasibility and technique of using the anterolateral thigh perforator flap pedicled with the lateral branch of the lateral circumflex femoral artery (LBLCFA) to repair soft tissue defect of extremities.

Eighty-six cases of anterolateral thigh perforator flap transplantation were performed from May, 2014 to May, 2018. A total of 37 cases of soft tissue defect of extremities were treated by anterolateral thigh perforator flap used the LBLCFA as vascular pedicle, of which there were 19 cases of upper limbs and 18 of lower limbs. There were 27 cases of defects caused by trauma, and 10 by soft tissue tumor resection. The flaps were designed centering around the point proximal to the midpoint of the iliac-patellar line. The dimensions of soft tissue defect were from 9.0 cm×6.0 cm to 26.0 cm×10.0 cm, and the flap were from 10.0 cm×7.0 cm to 27.0 cm×11.0 cm. The length of vascular pedicle ranged of 7.0-13.0 cm, with an average of 11.5 cm. The donor sites were directly sutured. All of the patients were followed-up regularly in the outpatient department.

All the flaps survived and the donor sites were primarily healed. Of these 37 cases, 2 trauma patients and 2 patients treated with local radiotherapy had poor wound healing, but still healed after multiple dressing changes. All the patients were followed-up for 3-26 months, with an average of 13 months. The texture, color and elasticity of the flap were similar to the surrounding tissue of the recipient sites, while only a linear scar remained at the donor sites. Ten tumor patients were treated with routine radiotherapy and chemotherapy after the repairation; there was no tumor recurrence during the follow-up period.

The LBLCFA gives off a relatively large and thick perforator proximal 5.0-7.0 cm of the iliac-patellar line, which locates in the upper lateral side, travels parallel to the vastus lateralis, and give off the skin and muscular perforators. The lateral branch can be used as pedicle to make into perforator flap or chimeric flap, which provides a novel selection of vascular pedicel for anterolateral thigh perforator flap. When the descending branch does not provide a thick and large perforator, the LBLCFA has important practical value and is worth utilizing in the clinic.

Lateral branch, lateral circumflex femoral artery; Anterolateral thigh flap; Tissue transplantation; Microsurgical technique