Long-term clinical value of the anterolateral thigh perforator flap in the repair of limb soft tissue defects: A case series.

Objective: To explore the long-term clinical value of the anterolateral thigh (ALT) perforator flap in the repair of limb soft tissue defects. Methodology: This retrospective analysis included clinical records of 62 patients with limb soft tissue defects who received ALT perforator flap treatment at Guigang People's Hospital from January 2020 to October 2024. The defect area ranged from 8×6 cm to 28×15 cm. The arteries, veins and sensory nerves of the perforator flap were microanastomosed with the corresponding structures of the recipient area and the donor area was directly sutured in one stage. Patients were followed up eight months to five years after surgery. Results: Postoperative follow-up ranged from 8~60 months (average 32.9 ± 13.4 months); 59 cases of skin flaps survived completely, with a success rate of 95.2%. Three patients had reported complications: one case had localized necrosis at the edge and two cases had full-thickness necrosis, which healed after debridement and skin grafting. The skin flap donor site was directly sutured without the occurrence of fascial compartment syndrome. The microcirculation of the surviving skin flap was good, the color coordinated with the surrounding tissues and the texture was flexible. Three patients underwent secondary volume reduction plastic surgery due to the large volume of the reconstruction area, which affected their function. The postoperative contour was satisfactory. Conclusions: Long-term follow-up has confirmed that the ALT perforator flap can be used as a reconstruction treatment plan for soft tissue defects in limbs.