Consideration of a thin flap as an entity and clinical applications of the thin anterolateral thigh flap.

A defatted (thinned) anterolateral thigh flap was designed to reconstruct skin defects requiring thin flap coverage. We used this flap as a free flap for five cases of skin defects, and the outcomes of the reconstructions were all successful. The vascular pedicle of this flap, the cutaneous perforator of the lateral circumflex femoral artery, is about 8 cm long and 2 mm in diameter, and it is ideal for microvascular anastomosis. Thinning is performed in about 3 to 4 mm of thickness almost uniformly except for the vascular pedicle. It was ascertained as one of the useful donor sites of the free thin flap. The virtue of the thin anterolateral thigh flap is its uniform thinness compared with other thin flaps reported previously--the thin groin flap and the thin rectus abdominis musculocutaneous flap. We considered thin flaps as an entity, and they are classified into three types.