The course of anterolateral thigh perforators does not correlate between sides of the body: the role for preoperative imaging

[Extract] The anterolateral thigh flap is well established as a versatile reconstructive option for a range of soft tissue defects, with excellent results reported. However, controversy exists regarding the reliability of the vascular anatomy of the flap. Some authors describe a consistent relationship of perforators to anatomical landmarks and between sides of the body, whereas others have described uncertainty in predicting individual perforator anatomy and advocated the use of preoperative imaging. A major advantage of preoperative imaging is the selection of the side of the body with better vascular anatomy. Computed tomographic angiography has been shown to be accurate in detecting the optimal perforator and limb for flap harvest. To confirm this benefit, the current study aimed to compare the course of anterolateral thigh perforators between body sides.