title: Creative Use of Contralateral Combined Myocutaneous Free Flap for Empyema Cavity.
abstract: Treatment of chronic postpneumonectomy empyema is a reconstructive problem that is always complicated by previous thoracic surgical procedures. Free flaps may be used because they effectively obliterate remaining pleural cavity dead space. Combined muscle free flaps with common vascular pedicles are viable alternatives when single muscle flaps do not possess adequate bulk. This case describes a contralateral combined latissimus dorsi-serratus anterior myocutaneous free flap with anastomoses to thoracodorsal vessels used for correction of chronic empyema. We also describe successful correction of a posterolateral chest wall defect using the adjacent axillary system as a recipient vessel. An accompanying skin paddle also enabled reliable cutaneous coverage of the external defect.
authors.affiliation: Alfred Health, Victoria, Melbourne, Australia; University of Cambridge, School of Clinical Medicine, Cambridge, United Kingdom. Electronic address: hannahb.tan@gmail.com.
authors.forename: Hannah B
authors.initials: HB
authors.lastname: Tan
authors.affiliation: Department of Plastic and Reconstructive Surgery, Addenbrooke's University Hospital, Cambridge, United Kingdom; Mayo Clinic, Rochester, Minnesota; Research Fellow at Restoration of Appearance and Function Charitable Trust (RAFT), London, United Kingdom.
authors.forename: Anita T
authors.initials: AT
authors.lastname: Mohan
authors.affiliation: Department of Thoracic Surgery, Papworth Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom.
authors.forename: Aman S
authors.initials: AS
authors.lastname: Coonar
authors.affiliation: University of Cambridge, School of Clinical Medicine, Cambridge, United Kingdom; Department of Plastic and Reconstructive Surgery, Addenbrooke's University Hospital, Cambridge, United Kingdom; Postgraduate Medical Institute at Anglia Ruskin University, Cambridge and Chelmsford, United Kingdom.
authors.forename: Charles M
authors.initials: CM
authors.lastname: Malata
mesh_terms: D016724:Empyema, Pleural / Q000601:surgery*; D058752:Free Tissue Flaps; D006801:Humans; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000637:transplantation*; D016038:Skin Transplantation / Q000379:methods*; D013905:Thoracoplasty / Q000379:methods*