Soft tissue reconstruction. Coverage of the chest wall and spine

Advances in reconstructive surgery achieved during the past decade have considerably broadened the range of options available for coverage of the chest wall and spine. Flaps can be designed to maximize function and provide bulk, bony rigidity, sensation, or function, when needed. Local musculocutaneous and muscle flaps are preferred, but, at times, a free flap is more appropriate, either because the local tissue is inadequate or because a free flap best meets the needs of the recipient site. With current techniques, donor-site morbidity, flap survival, and, ultimately, patient outcome can be optimized to a much greater extent than in years past.