{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T21:14:06Z","timestamp":1783977246702,"version":"3.55.0"},"reference-count":0,"publisher":"Georg Thieme Verlag KG","issue":"03","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J reconstr Microsurg"],"published-print":{"date-parts":[[2018,3]]},"abstract":"<jats:p>\n            Background\u2003Subfascial anterolateral thigh (ALT) flap thickness can be problematic with regards to bulk, oral competence, shoe-fit, or as a potential source of recurrent wound breakdown. We have utilized distinct upper thigh fascial planes to fashion thin (suprafascial) or super-thin (periscarpal) ALT flaps to improve surface topography. We compared outcomes based on ALT flap thickness to determine any significant differences in extremity coverage and reconstruction.<\/jats:p><jats:p>\n            Methods\u2003Analysis was completed on patients who consecutively underwent ALT free tissue transfer at a single institution from May 2012 to January 2017. Patient's operative, and postoperative characteristics were evaluated. Univariate analysis determined differences among matching as well as functional outcomes. A multivariable regression identified independent risk factors associated with patient, donor site, and flap complications.<\/jats:p><jats:p>\n            Results\u2003Fifty-one patients met inclusion criteria. Of these, 16 (31.4%) underwent traditional subfascial ALT flaps, and 35 (68.6%) underwent suprafascial (N\u2009=\u200923) or super-thin (N\u2009=\u200912) flaps. Thin flap patients were more likely to use tobacco (42.9% versus 6.3%; p\u2009&lt;\u20090.01), have fewer perforators (1.20\u2009\u00b1\u20090.41 versus 1.64\u2009\u00b1\u20090.63; p\u2009&lt;\u20090.009), and shorter mean operative times (425.9\u2009\u00b1\u200987.8 versus 511.9\u2009\u00b1\u200979.9; p\u2009&lt;\u20090.002), but nearly identical flap sizes (163 cm2 versus 168 cm2). There were no significant differences in flap complications (18% versus 22%) or donor-site complications (6.3% versus 5.7%) between the thick and thin cohorts, respectively (p\u2009&gt;\u20090.05). In subgroup analysis, diabetes mellitus was an independent risk factor for donor site morbidity (odds ratio [OR]\u2009=\u20091.23; p\u2009=\u20090.027) for all groups, whereas tobacco use and obesity (body mass index [BMI]\u2009&gt;\u200930) failed to significantly alter outcomes independently.<\/jats:p><jats:p>\n            Conclusions\u2003Tailoring ALT thickness can be performed safely without compromising flap outcomes or patient morbidity. Suprafascial and super-thin ALTs allowed for safe, precise solutions for tissue coverage.<\/jats:p>","DOI":"10.1055\/s-0037-1607426","type":"journal-article","created":{"date-parts":[[2017,11,7]],"date-time":"2017-11-07T23:46:09Z","timestamp":1510098369000},"page":"176-184","source":"Crossref","is-referenced-by-count":35,"title":["Outcomes of Subfascial, Suprafascial, and Super-Thin Anterolateral Thigh Flaps: Tailoring Thickness without Added Morbidity"],"prefix":"10.1055","volume":"34","author":[{"given":"Shawn","family":"Diamond","sequence":"first","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Havard Medical School, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akhil","family":"Seth","sequence":"first","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Havard Medical School, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anmol","family":"Chattha","sequence":"first","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Havard Medical School, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mathew","family":"Iorio","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Havard Medical School, Boston, Massachusetts"},{"name":"Department of Orthopedics, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2017,11,7]]},"container-title":["Journal of Reconstructive Microsurgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/s-0037-1607426.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2018,2,21]],"date-time":"2018-02-21T23:57:14Z","timestamp":1519257434000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/s-0037-1607426"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,11,7]]},"references-count":0,"journal-issue":{"issue":"03","published-online":{"date-parts":[[2018,2,21]]},"published-print":{"date-parts":[[2018,3]]}},"URL":"https:\/\/doi.org\/10.1055\/s-0037-1607426","relation":{},"ISSN":["0743-684X","1098-8947"],"issn-type":[{"value":"0743-684X","type":"print"},{"value":"1098-8947","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,11,7]]}}}