A Triple Pedicle, Near-Total Thigh Flap Supercharged With the Flow-Through Technique

This is the first instance where the technique of supercharging a flap with a second pedicle, combined with a third pedicle using the flow-through technique, is described in literature. We present the case of a 66-year-old man with multiple recurrent squamous and basal cell carcinomas of the face. He underwent a wide local excision resulting in a 20 × 26-cm defect. This was reconstructed with near-total thigh free flap. Three separate pedicles providing independent perforators to the medial, posterior-lateral, and anterolateral thigh from the superficial femoral artery, directly from the profunda femoris artery, and from the descending branch of the lateral circumflex artery were harvested. We expand upon the technique of supercharging a flap by not only anastomosing 3 separate pedicles but also using the flow-through technique to provide inflow and outflow to the third pedicle.