Coverage of chest wall and pelvic defects with the external oblique musculofasciocutaneous flap

The external oblique muscle, its fascia, and overlying skin have comprised flaps that have been used successfully in reconstructive surgery of various defects in the past. This flap provides good coverage for lower and upper chest wall defects to the level of the ipsilateral fourth rib. It provides skin of a similar color and texture and of large quantity. The skin of the flap is innervated; thus, sensation can be maintained. The remaining flat abdominal musculature and fascia maintain the integrity of the abdominal wall after transposition. We demonstrate that the external oblique musculofasciocutaneous flap can also be rotated in an inferior direction to close large hemipelvectomy defects in the absence of the usual ipsilateral thigh musculature.