Measurement for Subcutaneous Fat and Clinical Applied Anatomic Studies on Perforators in the Anterior Thigh Region

Purpose: To discuss the feasibility of making anterolateral thigh flaps of different thicknesses in the anterior thigh region and to provide clinical guidance on raising anterior thigh polyfoliate (myocutaneous) flaps. Patients and Methods: Sixty-six patients who underwent oral and maxillofacial malignant tumor resection and reconstruction with left anterior thigh flaps from October 2008 to April 2009 in the Second Xiangya Hospital were selected as the subjects. The thickness of subcutaneous fat in different parts of the anterior thigh region was measured and the distribution, number, type, and origin of cutaneous perforators in the left anterior thigh region were explored by anatomic observation. Results: The thickness of subcutaneous fat in the anterior thigh region was thinnest in the lower part, medium in the middle part, and thickest in the upper part. The probabilities of cutaneous perforators in the upper, middle, and lower parts of the anterolateral thigh region were 83.3%, 97%, and 89.4%, respectively, and those in the anteromedial thigh region were 51.5%, 84.9%, and 95.5%. On average, there were 4.4 cutaneous perforators in the anterolateral thigh region and 3.3 cutaneous perforators in the anteromedial thigh region of each patient. In addition, 57.6% of patients had cutaneous perforators arising from the descending branch of the lateral circumflex femoral artery in the anteromedial thigh region. Conclusions: Flaps with different thicknesses could be harvested in different parts of the anterolateral thigh region and polyfoliate (myocutaneous) flaps could be conveniently raised in the anterior thigh region. (C) 2013 American Association of Oral and Maxillofacial Surgeons J Oral Maxillofac Surg 71:951-959, 2013