Slobodni anterolateralni natkoljenični režanj

master's thesis

• Title (english): Free anterolateral thigh flap
• Author: Miro Bilić
• Mentor: Davor Mijatović (mentor)
• Committee member: Sanda Smuđ Orehovec (predsjednik povjerenstva)
• Committee member: Tomislav Meštrović (član povjerenstva)
• Committee member: Davor Mijatović (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Surgery); Zagreb
• Defense date and country: 2022-07-15, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Surgery

Abstract

Song i suradnici prvi su opisali anterolateralni natkoljenični (engl. anterolateral thigh, ALT) režanj 1984. godine. ALT režanj ima široku primjenu zbog brojnih prednosti: mogućnost rada u dva tima, duga peteljka režnja, prilagodba veličine i debljine, nizak morbiditet donorskog mjesta i dr. Također, ALT režanj omogućava uzimanje različitih tkivnih komponenti: kožu, fasciju i mišić u različitim kombinacijama. Najčešće indikacije za korištenje režanja su rekonstrukcija glave i vrata, gornjih i donjih udova, trbušne stijenke, ali režanj se koristiti i za rekonstrukciju dojke, jednjaka, perineuma i penilnu rekonstrukciju. ALT režanj temelji se na perforatorima silazne grane lateralne cirkumfleksne femoralne arterije. Pomoću kožnih orijentacijskih točaka i Doppler probe, preoperativno se označi približna lokacija perforatora. Perforatori mogu biti septokutani ili miokutani, što je češće slučaj. Ako je prisutan miokutani perforator, potrebno je napraviti intramuskularnu diskeciju. Osim silazne grane, peteljka režnja može biti i kosa grana. Režanj se uglavnom odiže subfascijalno. Najčešća komplikacija na donorskom mjestu je parestezija lateralnog dijela natkoljenice. Ostale ozbiljne komplikacije, poput kompartment sindroma ili mišićne nekroze, su moguće, ali rijetke. Stopa uspjeha režnja je visoka. Morbiditet donorskog mjesta je minimalan. U najvećem broju slučajeva, funkcija mišića je očuvana, a estetski rezultati su zadovoljavajući.

Abstract (english)

Song and colleagues were the first to describe the anterolateral thigh (ALT) flap in 1984. The ALT flap is widely used due to its many advantages: the possibility of working in two teams, long flap pedicle, adjustment of size and thickness, low morbidity of the donor site, etc. Also, the ALT flap allows taking different tissue components: skin, fascia and muscle in different combinations. The most common indications for using the flap are reconstruction of the head and neck, upper and lower limbs, abdominal wall, but the flap is also used for reconstruction of the breast, esophagus, perineum and penile reconstruction. The ALT flap is based on the perforators of the descending branch of the lateral circumflex femoral artery. Preoperatively, the approximate location of the perforator is marked using skin orientation points and Doppler probe. Perforators can be septocutaneous or myocutaneous, which is more often the case. If a myocutaneous perforator is present, intramuscular disection should be performed. In addition to the descending branch, the pedicle can be an oblique branch. The flap is usually incised subfascially. The most common complication at the donor site is paresthesia of the lateral part of the thigh. Other serious complications, such as compartment syndrome or muscle necrosis, are possible, but rare. The success rate of the flap is high. Donor site morbidity is minimal. In the majority of cases, muscle function is preserved, and aesthetic results are satisfactory.

• Keywords: anterolateralni natkoljenični režanj; ALT; perforatorski režanj; rekonstrukcijska kirurgija
• Keywords (english): anterolateral thigh flap; ALT; perforator flap; reconstructive surgery
• Language: croatian
• URN:NBN: urn:nbn:hr:105:751233
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2023-01-03 11:56:03