Does fascia lata repair facilitate closure and does it affect compartment pressures of the anterolateral thigh flap donor site?

The reliability and versatility of the anterolateral thigh flap has been established; however, reducing donor-site morbidity continues to be a focus. The major donor-site difficulties reported include wound complications related to primary closure (i.e., wound dehiscence, muscle bulge, need for skin grafting) and mild lower extremity weakness.1–3 Techniques to further decrease donor-site morbidity would further enhance appeal of the anterolateral thigh flap. Primary fascial closure or imbrication may decrease tension on the skin repair and allow primary closure of larger defects; however, its effect on compartment pressures has not yet been documented. We sought to demonstrate that primary closure or imbrication of the fascia lata following anterolateral thigh flap harvest could be performed safely and predictably, achieving higher rates of primary skin closure.