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Chapter 8 Table 8.3 Complications. DISCUSSION The pedicled myocutaneous TFL flap was first described in 1978 by Hill and Nahai5-6 for pressure sore coverage particularly in the throchanteric area. The authors showed that the pedicle of the TFL muscle is a branch of the lateral circumflex femoral artery. As one of the first free flaps in plastic surgery, the TFL musculocutaneous free flap was described by Mathes7 in 1979. In 2000 Deiler8 described the perforator TFL flap for reconstruction of composite Achilles tendon defects. The advantage of a perforator TFL com- pared to the original TFL flap was avoiding instability of the knee joint. The flap in this study was drawn on the longest axis of the TFL because a part of the fascia was included in the flap for the reconstruction of the Achilles tendon. Later, the TFL perforator flap has been described for head and neck reconstructions in case the anterolateral thigh flap was considered impossible or not safe to harvest9-10. In 2009 Hubmer11 performed a dissection study describing the anatomy of the perforators coming from the nourishing vessels of the TFL. He presented his experience with the use of the TFL perforator flap based on septocutaneous perforators in 17 clinical cases for groin, head and extremities reconstruction12. In 2013 the same flap, in the article described as superolateral thigh flap was studied by Vegas et al.13. The authors performed an anatomical study on 10 embalmed cadavers and a radiological study based on computer tomography angiography on 36 patients. The vascular anatomy of the ascending branch of the LCFA was analyzed in both groups with particular attention to the perforators reaching the skin. In the same study the authors presented a 143


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