How to deal with the vessel of free flap: A retrospective study of 264 cases of anterolateral thigh flap

Objective To compare the reliability and effectiveness of anterolateral thigh flap with double vein anastomosis or one vein anastomosis for reconstruction of head and neck defects. Methods Two hundred and sixty four cases of anterolateral thigh flap transfers for head and neck reconstruction from January, 2013 to September, 2013 in the Second Xiangya Hospital of Central South University were reviewed. 260 patients were randomly divided into 2 groups. In the experimental group, there were 138 patients 140 cases of anterolateral thigh flap with one vein one artery anastomosis. In the control group, there were 122 patients 124 cases of anterolateral thigh flap with double vein one artery anastomosis. Results Among 264 anterolateral thigh flaps, the overall success rate of free flap was 98.1% (259/264), 5 free flaps were lost. In the experimental group, there were 6 free flaps occurred venous thrombosis, two of them were lost. In the control group, there were 5 cases occurred venous thrombosis, three of them were lost. No arterial thrombosis occurred in both groups. The time of micromanipulation was 18 to 101 min, with the average of 47 min in the experimental group. In the control group, the time was 45 to 133 min, with the average of 71 min. (P= 0.0003). Conclusion Anterolateral thigh flap with one vein one artery anastomosis for head and neck reconstruction did not affect the survival rate but it can absolutely reduce the operation time. Key words: Anterolateral thigh flap; Micro-vessel anastomosis; Venous thrombosis; Head and neck; Retrospective study