Chest wall reconstruction using a turbocharged chimaeric anterolateral thigh flap.
Extremely large chest wall defects may result following salvage oncological surgery. Typically these defects involve a large skin defect combined with a variable resected area of underlying muscle and ribs. In situations where the skin defect is very large the use of a large latissimus dorsi flap may require skin grafting to the donor site if a myocutaneous flap is used or to the recipient defect if a muscle-only flap is used. Alternatively a transverse rectus abdominis flap is a second option but in certain cases this may not be available. We describe the use of a free anterolateral thigh flap to reconstruct a chest wall defect and demonstrate the principle of side-to-side stacking of separate skin paddles to achieve skin closure of a massive defect whilst permitting primary closure of the donor site. The principle of turbocharging components of a chimaeric flap is also described.
Gore
Sinclair M
SM
Department of Plastic Surgery and the RAFT Institute of Plastic Surgery Research, Mount Vernon Hospital, Northwood, Middlesex HA6 2RN, UK.
Akhavani
Mohammed A
MA
Kang
Norbert
N
Chana
Jagdeep S
JS
D000328:Adult; D001943:Breast Neoplasms / Q000601:surgery; D005260:Female; D006801:Humans; D015409:Mastectomy, Radical; D009364:Neoplasm Recurrence, Local / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000379:methods*; D016038:Skin Transplantation / Q000379:methods; D013524:Surgical Flaps; D035441:Thoracic Wall / Q000601:surgery*