Combined Thigh Flap for Closure of Massive Trunk Defect

ABSTRACT

A massive trunk defect resulting from resection of recurrent sarcoma was reconstructed with a combined free flap incorporating medial, anterior, and lateral thigh tissues. This flap included the tensor fasciae latae, lateral thigh perforator, and rectus femoris, all based on the lateral femoral circumflex pedicle. A saphenous vein conduit enabled this flap to replace resected tissues at the lower thorax. Combining the three different commonly used thigh flaps on a single large pedicle enabled transfer of a 47.5 × 33.5-cm mega-flap.

Trunk reconstruction - lateral thigh flap - rectus femoris - tensor fasciae latae - combined free flap

REFERENCES

• 1 Mathes S, Nahai F. Clinical Applications for Muscle and Myocutaneous Flaps. St. Louis, MO; C.V. Mosby 1982
• 2 Williams J, Carlson G, Howell R, Wagner J D, Nahai F, Coleman J J. The tensor fascia lata free flap in abdominal wall reconstruction.  J Reconstr Microsurg. 1997;  13 83-90
• 3 Koshima I, Moriguchi T, Inagawa K. Dynamic reconstruction of the abdominal wall using a reinnervated free rectus femoris muscle transfer.  Ann Plast Surg. 1999;  43 199-203
• 4 Sasaki K, Nozaki M, Nakazawa H, Kikuchi Y, Huang T. Reconstruction of a large abdominal wall defect using combined free tensor fasciae latae musculocutaneous flap and anterolateral thigh flap.  Plast Reconstr Surg. 1998;  102 2244-2252
• 5 Sekido M, Yamamoto Y, Sugihara T, Nohira K, Shintomi Y. Microsurgical reconstruction of chest- and abdominal-wall defects associated with intraperitoneal vessels.  J Reconstr Microsurg. 1996;  12 425-430
• 6 Kimata Y, Uchiyama K, Sekido M et al.. Anterolateral thigh flap for reconstruction of head and neck defects following cancer ablation.  Plast Reconstr Surg. 1999;  103 1191-1197
• 7 Miller M, Reece G, Marchi M, Baldwin B J. Lateral thigh free flap in head and neck reconstruction.  Plast Reconstr Surg. 1995;  96 334-340
• 8 Pribaz J, Orgill D, Epstein M, Sampson C E, Hergrueter C A. Anterolateral thigh flap.  Ann Plast Surg. 1995;  34 585-592
• 9 Koshima I, Fukuda H, Yamamoto H, Moriguchi T, Soeda S, Ohta S. Free anterolateral thigh flaps for reconstruction of head and neck defects.  Plast Reconstr Surg. 1993;  92 421-428
• 10 Kimata Y, Uchiyama K, Ebihara S, Nakatsuka T, Harii K. Anatomic variations and technical problems of the anterolateral thigh flap: a report of 74 cases.  Plast Reconstr Surg. 1998;  102 1517-1523