Tái tạo khuyết phức tạp chi dưới bằng vạt đùi trước - ngoài dạng chùm

Abstract

Complex lower extremity soft tissue defects are often associated with exposed tendons, bone, and osteomyelitis, requiring both durable coverage and functional reconstruction. A retrospective study was conducted on 13 patients with defects involving the lower leg, ankle, and foot reconstructed using chimeric anterolateral thigh flaps between January 2020 and January 2026. The flap consisted of a fasciocutaneous component and a vastus lateralis muscle component; the fasciocutaneous portion was used for coverage and tendon gliding surface reconstruction, whereas the muscle component was used to obliterate dead space and assist in infection control. All flaps included at least two perforators; flap size ranged from 8×6 cm to 32×12 cm, with a mean pedicle length of 10.3 cm. Two patients required early re-exploration because of microvascular complications, including one case of distal flap ischemia requiring secondary skin grafting; however, there was no total flap loss observed. Functional and aesthetic outcomes were satisfactory. As such, the chimeric anterolateral thigh flap is an effective option for reconstruction of complex lower extremity soft tissue defects, allowing simultaneous management of multiple anatomical components in a single-stage procedure.