{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T12:06:04Z","timestamp":1784203564088,"version":"3.55.0"},"reference-count":40,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2022,6,18]],"date-time":"2022-06-18T00:00:00Z","timestamp":1655510400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Microsurgery"],"published-print":{"date-parts":[[2022,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Treatment for large defects in the non\u2010weight\u2010bearing Achilles tendon and soft tissues remains a reconstructive challenge. The free composite anterolateral thigh flap (ALT) with fascia lata (FL) has been indicated in the single\u2010stage reconstruction of the Achilles tendon and soft tissue defect and this technique remain some disadvantages, such as the inability to perform primary flap thinning, requiring secondary flap thinning, and the delayed normalization of the range of motion of the ankle joint. The free chimeric ALT flap with FL was introduced as a novel alternative with many advantages in reconstructing the Achilles tendon and soft tissue defects. This paper reports the reconstruction of the massive Achilles tendon and overlying skin defects using free chimeric ALT flaps with FL.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>From June 2017 to October 2020, we performed on a series of 5 patients receiving free chimeric ALT flaps with FL to reconstruct the Achilles tendon and soft tissue defects. The age of patients ranged from 43 to 62\u2009years old. All five patients had full\u2010layer defects of the Achilles tendon with infection. The sizes of the skin defects ranged from 6\u2009\u00d7\u20094\u00a0cm to 12\u2009\u00d7\u200910\u00a0cm. The perforators from the descending branch of the lateral circumflex femoral arteries are located using a handheld Doppler. The perforators help to design the outline of the ALT flap and fascia flap. The skin flap was thinned under microscopy if the flap was too thick. The anastomosis was accomplished before insetting the flaps into the defect.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The size of the ALT flap ranged from 10\u2009\u00d7\u20095\u00a0cm to 15\u2009\u00d7\u200912\u2009cm, and the size of the FL flap ranged from 7\u2009\u00d7\u20094\u00a0cm to 10\u2009\u00d7\u20098\u00a0cm. The mean perforator length for the skin flap and fascia lata was 3.3\u00a0cm (range, 2.5\u20135.0\u00a0cm) and 5.3\u00a0cm (range, 3.5\u20137.0\u00a0cm), respectively. Four patients received skin flap thinning up to 57%\u201379% of the flap thickness, while one patient did not need to debulk. The thickness of the ALT flap ranged from 6 to 13\u2009mm. All the flaps survived completely and postoperative courses were uneventful without any complications. The follow\u2010up time ranged from 12 to 51\u2009months. All patients were able to stand and ambulate, and they were satisfied with the reconstructive results.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The free thin chimeric ALT with FL flap is appeared to be an appropriate treatment for the massive Achilles tendon and overlying skin defects. This may be a practical approach to improve the functional outcomes of patients with infected massive Achilles tendon and overlying skin defects.<\/jats:p><\/jats:sec>","DOI":"10.1002\/micr.30931","type":"journal-article","created":{"date-parts":[[2022,6,18]],"date-time":"2022-06-18T08:25:47Z","timestamp":1655540747000},"page":"659-667","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["One\u2010stage reconstruction of the massive overlying skin and Achilles tendon defects using a free chimeric anterolateral thigh flap with fascia lata"],"prefix":"10.1002","volume":"42","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6739-1059","authenticated-orcid":false,"given":"Tran Thiet","family":"Son","sequence":"first","affiliation":[{"name":"Department of Plastic Reconstructive and Aesthetic Surgery Bach Mai Hospital  Hanoi Vietnam"},{"name":"Department of Plastic Surgery Saint Paul Hospital  Hanoi Vietnam"},{"name":"Department of Plastic and Reconstructive Surgery Hanoi Medical University Hospital  Hanoi Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pham Thi Viet","family":"Dung","sequence":"additional","affiliation":[{"name":"Department of Plastic Reconstructive and Aesthetic Surgery Bach Mai Hospital  Hanoi Vietnam"},{"name":"Department of Plastic Surgery Saint Paul Hospital  Hanoi Vietnam"},{"name":"Department of Plastic and Reconstructive Surgery Hanoi Medical University Hospital  Hanoi Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ta Thi Hong","family":"Thuy","sequence":"additional","affiliation":[{"name":"Department of Plastic Reconstructive and Aesthetic Surgery Bach Mai Hospital  Hanoi Vietnam"},{"name":"Department of Plastic Surgery Saint Paul Hospital  Hanoi Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vu Hong","family":"Chien","sequence":"additional","affiliation":[{"name":"Department of Plastic Reconstructive and Aesthetic Surgery Bach Mai Hospital  Hanoi Vietnam"},{"name":"Department of Plastic Surgery Saint Paul Hospital  Hanoi Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Le Hong","family":"Phuc","sequence":"additional","affiliation":[{"name":"Department of Plastic Aesthetic Surgery Hue University of Medicine and Pharmacy Hospital  Hue Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Le Anh","family":"Huy","sequence":"additional","affiliation":[{"name":"Department of Plastic Reconstructive and Aesthetic Surgery Bach Mai Hospital  Hanoi Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,6,18]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/SAP.0b013e31819516cc"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.5999\/aps.2013.40.2.91"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1177\/1938640016640895"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1080\/23320885.2019.1635023"},{"issue":"4","key":"e_1_2_9_6_1","first-page":"309","article-title":"Functional reconstruction of acutely burnt achilles tendon with composite anterolateral thigh flap with fascia lata: A case report","volume":"30","author":"Andreu\u2010Sola V.","year":"2017","journal-title":"Annals of Burns and Fire Disasters"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-199810000-00044"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.I.01578"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0033-1343952"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otsr.2012.07.009"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/micr.30658"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.4081\/cp.2011.e134"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0032-1306367"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0b013e31824422da"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/0007-1226(90)90199-A"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.PRS.0000135332.97062.7F"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/00003086-198512000-00014"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjps.2015.07.004"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.SAP.0000041479.79049.71"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/micr.22494"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-200110000-00015"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.PRS.0000091248.41007.2D"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000637-199308000-00018"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.SAP.0000037270.95257.B9"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0b013e31826d1662"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-199907000-00017"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1054\/bjps.2000.3407"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000011995"},{"key":"e_1_2_9_29_1","article-title":"Dynamic reconstruction of Achilles tendon by free composite perforator flap with functional assessment","volume":"61","author":"Michel G","year":"2014","journal-title":"Annales de chirurgie plastique et esthetique"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fcl.2009.07.004"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0032-1306370"},{"key":"e_1_2_9_32_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.PRS.0000073975.01321.8B"},{"key":"e_1_2_9_33_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.sap.0000181342.25065.60"},{"key":"e_1_2_9_34_1","doi-asserted-by":"publisher","DOI":"10.1002\/micr.21972"},{"key":"e_1_2_9_35_1","doi-asserted-by":"publisher","DOI":"10.1002\/micr.22399"},{"key":"e_1_2_9_36_1","doi-asserted-by":"publisher","DOI":"10.1016\/0007-1226(84)90002-X"},{"key":"e_1_2_9_37_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2006.06.005"},{"key":"e_1_2_9_38_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-200105000-00031"},{"key":"e_1_2_9_39_1","doi-asserted-by":"publisher","DOI":"10.1002\/micr.22490"},{"key":"e_1_2_9_40_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-200106000-00028"},{"key":"e_1_2_9_41_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijsu.2015.12.035"}],"container-title":["Microsurgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/micr.30931","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/micr.30931","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/micr.30931","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,22]],"date-time":"2023-08-22T05:11:10Z","timestamp":1692681070000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/micr.30931"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,6,18]]},"references-count":40,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2022,10]]}},"alternative-id":["10.1002\/micr.30931"],"URL":"https:\/\/doi.org\/10.1002\/micr.30931","archive":["Portico"],"relation":{},"ISSN":["0738-1085","1098-2752"],"issn-type":[{"value":"0738-1085","type":"print"},{"value":"1098-2752","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,6,18]]},"assertion":[{"value":"2021-10-06","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-06-03","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-06-18","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}