Incorporating a Racket-Handle Skin Bridge and Venous Supercharging to Improve Reliability of the Distally Based Anterolateral Thigh Flap

Sir, The distally based anterolateral thigh flap is one anatomical variant of the versatile regional flap commonly employed to reconstruct large knee defects [1]. Venous congestion poses a common concern for such flaps as oedema can potentiate complications such as tip necrosis and eventually scar development. To limit loss of mobility secondary to scarring in the knee, the surgeon should take a preventative approach and optimise venous drainage when utilising anterolateral thigh flaps. We present a case combining two manoeuvres, the LETTERS