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A triceps musculocutaneous flap for chest-wall defects
C R Hartrampf1, L F Elliott, S Feldman
1Department of Surgery, Emory University School of Medicine, Atlanta, Ga.
Plastic and Reconstructive Surgery
|September 1, 1990
Summary
A posterior upper arm flap, utilizing the profunda brachii vessels and triceps muscle, effectively reconstructs chest wall defects. This versatile flap offers a solution for post-radiation wounds and TRAM flap failures, with no functional deficit reported.
Area of Science:
- Plastic Surgery
- Reconstructive Surgery
Background:
- Soft-tissue defects in the chest wall can arise from radiation therapy or complications of TRAM flap procedures.
- Reconstruction often requires well-vascularized tissue for optimal outcomes.
Observation:
- A posterior upper arm flap, incorporating the long head of the triceps muscle and profunda brachii vessels, was utilized in seven patients.
- The flap was employed to address defects from post-TRAM flap failure, post-radiation wounds, and as an ancillary flap in breast reconstruction.
Findings:
- The posterior upper arm flap successfully covered chest wall defects in all seven cases.
- Donor sites were closed primarily, and no subjective functional deficit was observed post-operatively.
- The flap is suitable for defects in the shoulder, axilla, and posterolateral back.
Implications:
- This flap provides a viable reconstructive option for challenging chest wall defects, particularly in patients with limited local tissue.
- Redundant upper arm tissue, common in certain patient demographics, is a key prerequisite.
- The technique offers a solution with minimal donor site morbidity.