Versatility of the free vastus lateralis muscle flap.

BACKGROUND A flap that carries sufficient tissue with satisfactory pedicle length or diameter and with minor donor site morbidity is an ideal option for the reconstructive surgeon. Many flaps have been described with each one having specific advantages. The vastus lateralis (VL)-muscle flap is among them, but no special attention has been given to its valuable use. To evaluate and to propagate the versatility of the free VL-muscle flap, this flap was used in different pathology and in different anatomic areas. METHODS Twenty-three patients with various defects after trauma and cancer therapy underwent reconstruction with 24 free VL-muscle flaps. RESULTS The flap provided excellent reconstruction in all cases. All flaps were successful. Secondary operations included two debulking procedures, respectively, and one regrafting of parts of the flap because of partial skin graft loss. The donor site morbidity was minimal and no patient suffered from permanent partial limb dysfunction. CONCLUSIONS The free VL-muscle flap is a versatile flap that offers specific advantages such as constant anatomy, ease of dissection in supine position, long pedicle length, large vessel diameter, good esthetic outcome, and minor donor site morbidity. This flap has proven to be most valuable also in difficult cases, including head and neck and lower limb reconstruction.