An Anatomic assessment on perforators of the lateral circumflex femoral artery for anterolateral thigh flap

The anterolateral thigh flap was originally described in 1984 as a septocutaneous flap based on the descending branch of the lateral femoral circumflex artery (LCFA). This flap has many advantages for head and neck reconstruction. However, it is not widely used as a result of the broad range of anatomic variation of the cutaneous perforators and because dissection of these perforators is tedious when they are small. The purposes of this study are to classify the vascular anatomy of the LCFA and to assess the suitability of the anterolateral thigh flap for head and neck reconstruction in Koreans. From 38 thigh dissections of Korean cadavers, the LCFA commonly arose from the deep femoral artery and divided into ascending, transverse, and descending branches. In five cases, the LCFA arose directly from the femoral artery. The cutaneous perforators were present in 37 cases except one and the septocutaneous perforators were found in 17 of the 38 cases. Of the 160 perforators, 28 (17.5%) were the septocutaneous perforators and 132 (82.5%) were the musculocutaneous perforators. The average number of cutaneous perforators for the anterolateral thigh flap was 4.2 (range, 0-8), and these perforators were concentrated in the middle third of the anterolateral thigh. The septocutaneous perforators were located more proximally than the musculocutaneous perforators. The average length of the vascular pedicle derived from the descending branch or the transverse branch was 83.3 mm (range, 53.4-124.3 mm). The results of this study suggest that the vascular anatomy of the anterolateral thigh flap was reliable and well suited for head and neck reconstruction in Koreans.