Combined thigh flap for closure of massive trunk defect

A massive trunk defect resulting from resection of recurrent sarcoma was reconstructed with a combined free flap incorporating medial, anterior, and lateral thigh tissues. This flap included the tensor fasciae latae, lateral thigh perforator, and rectus femoris, all based on the lateral femoral circumflex pedicle. A saphenous vein conduit enabled this flap to replace resected tissues at the lower thorax. Combining the three different commonly used thigh flaps on a single large pedicle enabled transfer of a 47.5 x 33.5-cm mega-flap.