Abstract: Objectives　To investigate the clinical application effect of the anterolateral thigh perforator flap for diabetic foot ulcer reconstruction.　Methods　A retrospective analysis was performed for the medical records of 35 patients from March 2020 to March 2024 who were treated with free anterolateral thigh perforator flap for diabetic foot ulcer reconstruction, the average age of the patients was 62 years old (45 to70 years), wound size was 5.0cm×6.5cm~24.0 cm×8.0cm. Wound location: 11 cases of forefoot, 9 cases of dorsum of feet, 9 cases of soles of feet, and 6 cases of heels. In all patients, infection was controlled by first-stage debridement and VSD negative pressure drainage.  The wound was repaired by free transplantation of anterolateral thigh perforator flap in the second stage.　Results　All patients had varying degrees of arteriosclerosis in the donor site, 3 cases had arterial occluded with flap, 1 case was salvaged, and 2 cases had failed and amputation. One case had venous crisis, effusion under the flap, partial necrosis, wound healing after dressing change, and the rest of the flaps survived completely, with a survival rate of 91.4% (32/35) and the limb salvage rate of 94.3% (33/35). Six months after operation, all patients were able to walk independently, and the AOFAS score of foot and ankle function was 73-95 points, with a median average of 87 points. After  6-18 months follow-up, no recurrence was observed.　Conclusions　The anterolateral thigh perforator flap is used to repair diabetic foot ulcers, which can reduce the recurrence and amputation rates, and obtain satisfactory function and appearance. 

Key words: Anterolateral thigh perforator flap, 　Diabetic foot, 　Ulceration, 　Vacuum sealing drainage, 　Wound repair