目的　探索一期原位修薄的股前外侧穿支皮瓣游离移植修复足远端创面缺损的可行性。  方法　2009年1月至2010年8月,应用游离股前外侧穿支皮瓣移植修复足终末端创面9例。术中皮瓣切取根据创面需要，或原位保留深层皮下脂肪和深筋膜于供区（6例），或保留全层脂肪和深筋膜于供区（3例）。皮瓣供区直接缝合或中厚皮片植皮。 平均手术时间为4.0 h。皮瓣大小为12 cm×8 cm～16 cm×10cm。  结果　本组1例术后出现静脉危象，经探查后好转。其余8例愈合顺利，未有无边缘坏死，全部病例皮瓣供区植皮未出现坏死。随访3～16个月，皮瓣质地外观良好，比常规切取的游离穿支皮瓣厚度减少一半，术后双足穿同样尺码的鞋，患者无再次修薄的要求。  结论　应用一期原位修薄的游离股前外侧穿支皮瓣修复足终末端创面，血供可靠，外形更好，无需二期修薄。

Objective　To explore the feasibility of the in situ one-stage thinning of the anterolateral thigh perforator flap for repairing the distal foot defects.　Methods　From Jun. 2009 to Aug. 2010, 9 cases with distal foot defects were treated with anterolateral thigh perforator flap. During the harvesting of the flap, either the deep layer of the subcutaneous fat and the deep fascia were preserved in situ (6 cases) or the whole layer of the subcutaneous fat and the deep fascia were preserved in situ (3 cases) according to the wound requirements. The donor sites were directly closed or covered with split-thickness skin grafts. The average operating time was 4.0 hours. The flap size ranged from 12×8cm～16cm×10cm.　Results　One flap had vein thrombosis postoperatively and the complication was solved after the re-exploration. The other 8 flaps healed uneventfully without any marginal necrosis. There was no skin grafts loss on the donor sites. At a 3~16 months follow up, the flaps took well with good contours. The thickness of these flaps was half of those harvested with common ways. The patients could wear the same size shoes postoperatively, and none of them required the thinning or debulking of the flaps.　Conclusions　In situ one-stage thinning of the anterolateral thigh perforator flap is a good technique for the distal foot defects. It has the advantages of the reliable blood supply, more satisfactory contours and requires no secondary thinning.