A pedicled anterolateral thigh flap for reconstruction of abdominal wall soft tissue defect in the absence of microsurgical services- case report.

INTRODUCTION: The anterolateral thigh (ALT) flap is a known work horse flap for coverage of range of soft tissue defects. It is utilized both as pedicled and free flap. It is a versatile flap that covers large area of cutaneous territory and which can be augmented with the vastus lateralis muscle for bulk or with the tensor fascia for fascia reconstruction. It has a long, wide caliber pedicle which gives it the freedom to be mobilized proximally to the level of the xiphoid process of the sternum and distally to the level of the knee.

CASE PRESENTATION: We have presented here a case of a 19-year old man with blast injury to the abdomen where we have used pedicled antero-lateral thigh flap to cover a large abdominal wall defect.

DISCUSSION: The anterolateral thigh flap is a workhorse flap in reconstructive surgery that can be used as a durable coverage for abdominal wall defects -to protect the abdominal viscera and avoid loss of domain and other disruptions of normal physiology.

CONCLUSION: The pedicled anterolateral thigh (ALT) flap was performed under 3.5× loupe magnification, demonstrating the feasibility of using this technique for abdominal wall defects in settings without full microsurgical services. While the procedure can be performed without an operating microscope, it still requires basic microsurgical equipment-such as loupes-and fundamental microsurgical skills, underscoring the importance of proficiency in these essential techniques.