Reconstructing chest walls with vertical abdominal fasciocutaneous flaps

Our experience with the vertical fasciocutaneous flap in the reconstruction of chest wall defects is described. The vascular supply of this vertical abdominal fasciocutaneous flap comes from perforating vessels stemming from superior epigastric vessels. The flap can be elevated in the same way as a standard fasciocutaneous or vascular island flap with a small part of the rectus muscle and superior epigastric vessels attached. This type of flap was used in 16 patients with major anterior chest wall excisional defects. The average size of the flap was approximately 10 by 33 cm. Superficial necrosis was observed in 2 patients and distal 2 cm total skin loss was observed in one patient. All other flaps survived completely.