Extended cutaneous 'thoracoabdominal' flap for large chest wall reconstruction

Area of Science:

• Plastic Surgery
• Surgical Oncology
• Thoracic Surgery

Background:

• Major chest wall reconstruction is often necessary after extensive cancer surgery or radionecrosis.
• Existing flap options, like musculocutaneous flaps, are common but may not suit all patients.
• Patients requiring reconstruction often have poor general health, necessitating efficient and safe techniques.

Purpose of the Study:

• To introduce and evaluate an extended pure cutaneous thoracoabdominal flap for large chest wall defects.
• To assess the safety, efficacy, and outcomes of this flap in patients with poor prognoses.
• To provide an alternative reconstructive option for complex chest wall defects.

Main Methods:

• The study involved 18 female patients undergoing major chest wall reconstruction between February 2002 and 2005.
• An extended pure cutaneous flap was harvested from the omolateral thoracoabdominal area.
• Vascular supply was ensured by lateral cutaneous branches of intercostal, subcostal, and lumbar arteries.

Main Results:

• Flap dimensions varied from 15x15 cm to 25x30 cm, successfully covering extensive defects.
• No major complications were recorded.
• Minor partial flap loss occurred in four cases, with only one requiring further debridement.

Conclusions:

• The extended cutaneous thoracoabdominal flap is a viable, quick, single-stage procedure for major chest wall reconstruction.
• It demonstrates a low morbidity rate and is particularly suitable for patients with poor prognoses.
• This technique offers an effective solution for extensive chest wall defects in compromised patients.