title: Flow-through omental flap to free anterolateral thigh flap for complex chest wall reconstruction: Case report and review of the literature.
abstract: Despite the options currently available for chest wall reconstruction, patients with complex composite defects may still pose a significant challenge for the reconstructive surgeon when only using conventional methods. In particular, prior radiotherapy and/or large en bloc resection may leave inadequate regional flaps and recipient vessels for free tissue transfer. Here, we describe a case in which we reconstruct a 14 cm × 18 cm complex chest wall defect, secondary to tumor resection and infected sternum debridement, with a pedicled flow-through omental flap to a 14 cm × 22 cm free anterolateral thigh flap using the omental gastroepiploic vessels as recipient vessels. Reconstruction was successful with excellent flap viability, and no complications at recipient or donor sites. We review the literature on complex chest wall reconstruction and introduce this valuable option of utilizing a pedicled omental flap as a flow-through flap to a free flap for patients without viable recipient vessels or local flaps.
authors.affiliation: Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University Medical Center, Stanford, CA.
authors.forename: Anna
authors.initials: A
authors.lastname: Luan
authors.affiliation: Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University Medical Center, Stanford, CA.
authors.forename: Michael G
authors.initials: MG
authors.lastname: Galvez
authors.affiliation: Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University Medical Center, Stanford, CA.
authors.forename: Gordon K
authors.initials: GK
authors.lastname: Lee
mesh_terms: D000328:Adult; D058752:Free Tissue Flaps; D006801:Humans; D008297:Male; D009361:Neoplasm Invasiveness; D009852:Omentum / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000379:methods*; D013848:Thigh / Q000601:surgery; D013899:Thoracic Neoplasms / Q000473:pathology / Q000601:surgery*; D035441:Thoracic Wall / Q000601:surgery*