Tensor Fasciae Lata Flap: Advanced Reconstruction Techniques for Postoperative Soft Tissue Defects

This book chapter presents a case report and discussion on the use of the tensor fasciae latae (TFL) flap for the reconstruction of a postoperative soft tissue defect with an exposed vascular implant in the right femoral region. The chapter includes a detailed case presentation, operative procedure, and a comprehensive discussion of the surgical technique, advantages, and limitations associated with the TFL flap.

The case presentation describes a patient with an exposed vascular polytetrafluoroethylene (PTFE) implant in the right groin region following interposing PTFE vascular implantation surgery. On examination, a soft tissue defect without signs of infection was observed. The surgical intervention involved reconstruction using sartorius transposition and TFL flaps. The wound was debrided, the defect size was measured, and the TFL flap was raised. The upper segment of the sartorius muscle was mobilized to cover the exposed vascular implant, followed by transposition of the TFL flap to cover the soft tissue defect. The donor site was grafted with split-thickness skin grafts. The postoperative period was uneventful, and satisfactory results were observed during follow-up examinations.

The discussion section introduces the TFL flap as a surgical technique used for the reconstruction of soft tissue defects in the hip, groin, and thigh regions. The surgical steps, including patient evaluation and planning, flap design and marking, incision and flap elevation, and flap transposition and closure, are described in detail. The advantages of the TFL flap, such as its proximity to the defect, tissue thickness and contouring, reliable blood supply, and minimized donor site morbidity, are discussed. The limitations, including the size and location of the defect, scar visibility, and potential complications, are also addressed.

In conclusion, this book chapter provides valuable insights into the use of the TFL flap for the reconstruction of soft tissue defects in the hip, groin, and thigh regions. Through a case report, operative details, and a comprehensive discussion, the chapter highlights the efficacy, considerations, and potential limitations associated with this surgical technique. This information can guide surgeons in making informed decisions and achieving successful outcomes in the reconstruction of soft tissue defects using the TFL flap.