Perforator-based propeller flaps for reconstruction of massive anterolateral thigh donor site wounds

Background: Wide anterolateral thigh (ALT) flap donor site defects may make primary closure difficult or impossible, with split thickness skin grafting and/or negative pressure therapy often used instead. Here, we describe a technique using propeller flaps based on varying thigh perforating vasculature in donor site reconstruction for these larger deformities.

Methods: Case series RESULTS: Three patients are described that had perforator-based propeller flap reconstruction of large ALT donor site wounds that were not amenable to primary closure. Two propeller flaps were supplied by perforators of the transverse branch of the lateral circumflex femoral artery and one by a perforator of the deep femoral system. One patient experienced partial loss of the propeller flap, but completely healed with local wound care.

Conclusion: The propeller flap is a safe method to reconstruct large ALT donor sites not amenable to primary closure.