title: [Combined split ALT/TFL flap for soft tissue coverage in large thoracical defects].
abstract: BACKGROUND
  Large, ulcerating tumors of the chestwall require soft tissue coverage after resection. Depending on size and location usually a latissimus dorsi flap, VRAM or TRAM flap is performed. In very large defects a combined split ALT/TFL flap is a new technique for coverage.
  
  
  METHODS
  In 4 patients (3 female, 1 male) a soft tissue reconstruction after tumor resection was necessary. The mean age was 54 years. The mean size of the defect was 656 cm(2).
  
  
  RESULTS
  In 3 cases the coverage was achieved by a unilateral, and in 1 case a bilateral combined split ALT/TFL flap. All flaps healed without flap loss. The donor site closure was achieved primarily in 2 cases. In 3 cases a small split skin graft was needed.
  
  
  CONCLUSIONS
  The indications for combined split ALT/TFL flaps are large defects which cannot be covered by one single flap. The combination of these two long-known flaps on one pedicle is a new development.
authors.affiliation: Ethianum Klinik Heidelberg, Vossstr. 6, 69115, Heidelberg, Deutschland, michael.pelzer@ethianum.de.
authors.forename: M
authors.initials: M
authors.lastname: Pelzer
authors.forename: G
authors.initials: G
authors.lastname: Germann
authors.forename: C
authors.initials: C
authors.lastname: Czermak
authors.forename: M
authors.initials: M
authors.lastname: Reichenberger
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000473:pathology / Q000601:surgery; D044584:Carcinoma, Ductal / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D058922:Inflammatory Breast Neoplasms / Q000601:surgery; D008297:Male; D008875:Middle Aged; D064827:Myocutaneous Flap / Q000601:surgery*; D009364:Neoplasm Recurrence, Local / Q000601:surgery; D061525:Perforator Flap / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000379:methods*; D012086:Reoperation; D012509:Sarcoma / Q000601:surgery; D012983:Soft Tissue Neoplasms / Q000601:surgery*; D013899:Thoracic Neoplasms / Q000601:surgery*; D035441:Thoracic Wall / Q000601:surgery*; D013964:Thyroid Neoplasms / Q000601:surgery; D020858:Tissue and Organ Harvesting / Q000379:methods