Comparison of Posteromedial Thigh Profunda Artery Perforator Flap and Anterolateral Thigh Perforator Flap for Head and Neck Reconstruction

Purpose:

The anterolateral thigh perforator flap is a common workhorse flap for head and neck reconstruction. We presented an alternative method using the posteromedial thigh profunda artery perforator flap and compared its flap characteristics, outcomes, donor-site morbidity and donor-site cosmesis with those of the anterolateral thigh perforator flap.

Methods:

Between May of 2013 and July of 2014, forty-one patients undergoing head and neck reconstruction, including 18 posteromedial thigh profunda artery perforator flaps and 23 anterolateral thigh perforator flaps were included in this study. Thirty-eight were men, and the patient age ranged from 32 to 76 years (mean, 54.5 years). The mean follow-up time was 9.3 months (range, 6-17 months).

Results:

The success rate was 100 percent. The mean perforator numbers were significantly higher in the profunda artery perforator flap group (2.0 versus 1.5). There was no significant difference in follow-up time (8.3 versus 10 months), flap elevation time (66.3 versus 60.7 minutes), pedicle length (9.8 versus 10 cm), flap area (166.1 versus 156.8 cm²), flap width (7.7 versus 7.7 cm), re-exploration rate (11.1 versus 4.3 percent), recipient-site complication rate (11.1 versus 4.3 percent), or donor-site complication rate (5.6 versus 4.3 percent). Based on patient-self assessment, the profunda artery perforator flap group had a significantly better donor-site cosmesis than the anterolateral thigh perforator flap group.

Conclusion

The posteromedial thigh profunda artery perforator flap is a good alternative for head and neck reconstruction. It offers comparable flap size, pedicle length, flap elevation time, and success rate as the anterolateral thigh perforator flap. It is advantageous in having higher perforator numbers and better donor-site cosmesis than the anterolateral thigh perforator flap. We recommend the posteromedial thigh profunda artery perforator flap as a simple and reliable perforator flap for microsurgical head and neck reconstruction.