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Article

Anterior Lateral Thigh Perforator (ALTP) Flaps: Literature Review and Technical Experience to Pushing the Limits Toward Aesthetical Reconstruction

by
Ziyad Alharbi
1,2,
Sarah Qari
1,
Tala Zafar
3,*,
Faris Almarzouqi
4,
Benedikt Schaefer
5,
Johannes Hertelendy
6,
Savas Tsolakidis
7,
Anas Fathuldeen
8 and
Hans-Oliver Rennekampff
9
1
Plastic Surgery and Burn Unit, Dr. Soliman Fakeeh Hospital, Jeddah 23323, Saudi Arabia
2
Clinical Sciences Department, Fakeeh College for Medical Sciences, Jeddah 23323, Saudi Arabia
3
College of Medicine, King Abdulaziz University (KAU), Jeddah 21589, Saudi Arabia
4
Department of Plastic Surgery, Dr. Sulaiman Al-Habib Hospital, Jeddah 22245, Saudi Arabia
5
Department of Plastic Surgery and Burn Unit, RWTH Aachen University, 52062 Aachen, Germany
6
Department of Plastic Surgery, Kaiserswerther Diakonie Florence-Nightingale-Krankenhaus, 40489 Düsseldorf, Germany
7
Austrian Cluster of Tissue Regeneration and Ludwig Boltzmann Institute for Experimental and Clinical Traumatology, Research Centre for Traumatology of the Austrian Workers’ Compensation Board (AUVA), Donaueschingenstraße 13, 1200 Vienna, Austria
8
College of Medicine, Hail University, Hail 55476, Saudi Arabia
9
Department of Plastic and Aesthetic Surgery, Burn Surgery, Rhein-Maas Klinikum, 52146 Würselen, Germany
*
Author to whom correspondence should be addressed.
Medicina 2025, 61(12), 2154; https://doi.org/10.3390/medicina61122154
Submission received: 2 August 2025 / Revised: 27 September 2025 / Accepted: 11 November 2025 / Published: 3 December 2025
(This article belongs to the Special Issue New Insights into Plastic and Reconstructive Surgery)
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Abstract

Background and Objectives: Free tissue transfer for coverage of large defects is a common technique in plastic surgery. The kind of free tissue transfer depends on various factors such as the size of the defect, type and content of missing tissue, the location, and the weight-bearing demands of the area. Instead of performing bulky muscle free flaps, another alternative has bas been considered. Materials and Methods: This is a technical experience report for ALTP Flap Surgery conducted from 2013 to 2017 which included 15 surgery reviews out of 50 based on the inclusion criteria to identify the result of aesthetical reconstruction and to include such results with the current literature. In addition to that, a narrative review of the literature has been performed using PubMed and Google Scholar by using the ALT or ALTP Flap terms to determine the current practice and to compare with our results. Results: Single-stage debridement of all defects was followed by reconstruction in all surgeries. A total of 14 Flaps succeeded (93.3%) without any complications and only one of the flaps was complicated (6.7%) with vein thrombosis which resulted in the loss of that flap, leading to another revision being performed for that particular patient. No hematoma or infection has been noted. Conclusions: Using an extended-size ALTP flap can be a reliable option for the reconstruction of the weight-bearing area of the foot and offers a good postoperative function and esthetic result without the need of further subsequent debulking procedures.
Keywords: ankle; anterior lateral thigh perforator flaps; extremity; fasciocutaneous flaps; foot; free flaps; reconstruction ankle; anterior lateral thigh perforator flaps; extremity; fasciocutaneous flaps; foot; free flaps; reconstruction

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MDPI and ACS Style

Alharbi, Z.; Qari, S.; Zafar, T.; Almarzouqi, F.; Schaefer, B.; Hertelendy, J.; Tsolakidis, S.; Fathuldeen, A.; Rennekampff, H.-O. Anterior Lateral Thigh Perforator (ALTP) Flaps: Literature Review and Technical Experience to Pushing the Limits Toward Aesthetical Reconstruction. Medicina 2025, 61, 2154. https://doi.org/10.3390/medicina61122154

AMA Style

Alharbi Z, Qari S, Zafar T, Almarzouqi F, Schaefer B, Hertelendy J, Tsolakidis S, Fathuldeen A, Rennekampff H-O. Anterior Lateral Thigh Perforator (ALTP) Flaps: Literature Review and Technical Experience to Pushing the Limits Toward Aesthetical Reconstruction. Medicina. 2025; 61(12):2154. https://doi.org/10.3390/medicina61122154

Chicago/Turabian Style

Alharbi, Ziyad, Sarah Qari, Tala Zafar, Faris Almarzouqi, Benedikt Schaefer, Johannes Hertelendy, Savas Tsolakidis, Anas Fathuldeen, and Hans-Oliver Rennekampff. 2025. "Anterior Lateral Thigh Perforator (ALTP) Flaps: Literature Review and Technical Experience to Pushing the Limits Toward Aesthetical Reconstruction" Medicina 61, no. 12: 2154. https://doi.org/10.3390/medicina61122154

APA Style

Alharbi, Z., Qari, S., Zafar, T., Almarzouqi, F., Schaefer, B., Hertelendy, J., Tsolakidis, S., Fathuldeen, A., & Rennekampff, H.-O. (2025). Anterior Lateral Thigh Perforator (ALTP) Flaps: Literature Review and Technical Experience to Pushing the Limits Toward Aesthetical Reconstruction. Medicina, 61(12), 2154. https://doi.org/10.3390/medicina61122154

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