{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T08:58:43Z","timestamp":1790585923107,"version":"4.1.0"},"reference-count":22,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T00:00:00Z","timestamp":1787616000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T00:00:00Z","timestamp":1787616000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Microsurgery"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The anterolateral thigh (ALT) flap is a versatile reconstructive option for head and neck defects but may be excessively bulky in contour\u2010sensitive regions. Super thin ALT flaps (\u2264\u200910\u2009mm) have been introduced to improve pliability and contour; however, their comparative clinical advantages over established fasciocutaneous flaps remain unclear. This study aimed to evaluate the clinical outcomes of super thin ALT flaps and to compare them with radial forearm free flaps (RFFF) in head and neck reconstruction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective study was conducted on patients who underwent head and neck reconstruction with super thin ALT flaps between 2021 and 2023 at a single tertiary center. A comparative cohort of patients reconstructed with RFFF during the same period was also included. Super thin ALT flaps were elevated within the superficial fascial layer with a target thickness of \u2264\u200910\u2009mm. Outcomes assessed included complication rates, fistula formation, reoperation, flap failure, and operative time. Postoperative drain amylase levels were analyzed as a surrogate marker for salivary leakage.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 28 patients in the super thin ALT group and 44 in the RFFF group were included in the analysis. All ALT flaps survived without partial necrosis. There were no statistically significant differences between the groups in total complication rate (7.1% vs. 11.3%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.692), fistula formation (3.5% vs. 6.8%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20091.000), reoperation (7.1% vs. 11.3%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.692), or operative time (145\u2009\u00b1\u200934\u2009min vs. 159\u2009\u00b1\u200942\u2009min,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.125). No flap failure occurred in the super thin ALT group, whereas three cases (6.8%) were observed in the RFFF group. The super thin ALT group demonstrated lower postoperative amylase levels, although the difference was not statistically significant.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Super thin ALT flaps provide clinical outcomes comparable to those of RFFF while offering enhanced pliability and improved conformity to complex defects. These characteristics make them a reliable and versatile alternative for head and neck reconstruction, particularly in contour\u2010sensitive regions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/micr.70278","type":"journal-article","created":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T09:43:48Z","timestamp":1787651028000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Comparative Outcomes of Super Thin Anterolateral Thigh Flaps Versus Radial Forearm Free Flaps in Head and Neck Reconstruction"],"prefix":"10.1002","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-6665-7789","authenticated-orcid":false,"given":"Kyung Jun","family":"Heo","sequence":"first","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery Yonsei University College of Medicine, Severance Hospital  Seoul Republic of Korea"},{"name":"Institute for Human Tissue Restoration, Yonsei University College of Medicine  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Woo Yeol","family":"Baek","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery Yonsei University College of Medicine, Severance Hospital  Seoul Republic of Korea"},{"name":"Institute for Human Tissue Restoration, Yonsei University College of Medicine  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Won Jai","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery Yonsei University College of Medicine, Severance Hospital  Seoul Republic of Korea"},{"name":"Institute for Human Tissue Restoration, Yonsei University College of Medicine  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Young Chul","family":"Suh","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery Yonsei University College of Medicine, Severance Hospital  Seoul Republic of Korea"},{"name":"Institute for Human Tissue Restoration, Yonsei University College of Medicine  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,25]]},"reference":[{"issue":"6","key":"e_1_2_13_2_1","first-page":"464","article-title":"Thin Anterolateral Thigh Flap in Head and Neck Reconstruction","volume":"30","author":"Acosta R.","year":"2010","journal-title":"Microsurgery"},{"issue":"2","key":"e_1_2_13_3_1","first-page":"103","article-title":"Free Flap Thinning: Systematic Review of Complications","volume":"35","author":"Bekara F.","year":"2015","journal-title":"Microsurgery"},{"key":"e_1_2_13_4_1","first-page":"215","volume-title":"Flaps in Head and Neck Reconstruction","author":"Chana J. 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G.","year":"2013","journal-title":"Journal of Reconstructive Microsurgery"},{"issue":"4","key":"e_1_2_13_8_1","first-page":"457","article-title":"Aesthetic and Functional Outcomes of ALT Flaps in Head and Neck Reconstruction","volume":"41","author":"He Y.","year":"2012","journal-title":"International Journal of Oral and Maxillofacial Surgery"},{"issue":"1","key":"e_1_2_13_9_1","first-page":"29","article-title":"Thinned Perforator Flaps: Definition and an Algorithm to Safe Flap Thinning","volume":"44","author":"Hong J. P.","year":"2017","journal-title":"Clinics in Plastic Surgery"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006534\u2010199604001\u201000016"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006534\u2010200110000\u201000015"},{"issue":"2","key":"e_1_2_13_12_1","first-page":"191","article-title":"Super Thin Flaps: Evolution and Current Status","volume":"47","author":"Koshima I.","year":"2020","journal-title":"Clinics in Plastic Surgery"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0b013e31826d9e1f"},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.1055\/s\u20100035\u20101563722"},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000637\u2010200203000\u201000004"},{"issue":"6","key":"e_1_2_13_16_1","first-page":"411","article-title":"Radial Forearm Flap Donor\u2010Site Complications and Morbidity","volume":"50","author":"Richardson D.","year":"1997","journal-title":"British Journal of Plastic Surgery"},{"key":"e_1_2_13_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0b013e31819f2c6a"},{"key":"e_1_2_13_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/0007-1226(83)90002-4"},{"key":"e_1_2_13_19_1","doi-asserted-by":"publisher","DOI":"10.5999\/aps.2020.01802"},{"key":"e_1_2_13_20_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-200206000-00007"},{"key":"e_1_2_13_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/B978-0-7216-0519-7.00017-4"},{"key":"e_1_2_13_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.21284"},{"key":"e_1_2_13_23_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.10400"}],"container-title":["Microsurgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/micr.70278","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/micr.70278","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/micr.70278","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T08:33:55Z","timestamp":1790584435000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/micr.70278"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,25]]},"references-count":22,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2026,9]]}},"alternative-id":["10.1002\/micr.70278"],"URL":"https:\/\/doi.org\/10.1002\/micr.70278","archive":["Portico"],"relation":{},"ISSN":["0738-1085","1098-2752"],"issn-type":[{"value":"0738-1085","type":"print"},{"value":"1098-2752","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,25]]},"assertion":[{"value":"2025-11-11","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-27","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-25","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70278"}}