Intrathoracic application of the transverse rectus abdominis musculocutaneous flap

The use of extrathoracic muscles for intrathoracic transposition of healthy tissues for correction of intrathoracic pathology has many precedents. The lower transverse rectus abdominis musculocutaneous flap as elevated in a manner identical to that more commonly used for breast reconstruction may also serve that role especially for basilar thoracic defects if more traditional muscle flap options are unavailable. A unique case of intrathoracic transfer of a lower transverse rectus abdominis musculocutaneous flap for obliteration of a chronic empyema cavity is presented.