Systematic Review: Anterolateral Thigh Flap Outcomes in High-Risk Diabetic Foot Reconstruction
Summary: Meta-analysis of 28 studies (n=1,147 limbs) evaluating anterolateral thigh (ALT) free flaps for diabetic foot reconstruction in high-risk patients (neuropathy, PAD, CKD, poor glycemic control). Overall flap survival 92.4%, complete healing 89.1%, limb salvage rate 93.7% at mean 28-month follow-up. Complications: partial necrosis 9.8%, re-operation 12.4%. ALT flaps remain reliable even in severe comorbidity settings, offering durable coverage and high limb-salvage rates for complex DFUs.
Key Highlights:
- Studies: 28 (2010–2025).
- Flap survival: 92.4%; healing: 89.1%; limb salvage: 93.7%.
- Comorbidities: CKD, PAD, poor HbA1c tolerated.
- Complications: Partial necrosis 9.8%, re-operation 12.4%.
- Authors: Multiple (systematic review team).
Keywords: ALT flap, anterolateral thigh, diabetic foot reconstruction, limb salvage, free flap, meta-analysis