The anterolateral thigh flap with kiss technique for microsurgical reconstruction of oncological scalp defects

Defects after radical resection of scalp tumor feature extensive size, complexity of composite defect and poor elasticity of surrounding original tissue1. The anterolateral thigh (ALT) flap is one of the most frequently used workhorses for scalp reconstruction. However, most scalp defects are rounded instead of oval shaped and prone to be significantly wider than the maximal transverse diameter of classical ALT flap when direct closure of donor site is scheduled. Recently, Zhang et al.2 developed the concept of "economy in autologous flap transfer" and reported on the kiss technique in order to both reduce donor site morbidity and enable optimal soft tissue coverage.