Abstract
Background The lateral thoracic donor site provides two types of perforator flap; the latissimus
dorsi perforator flap based on the musculocutaneous perforator, and the thoracodorsal
perforator flap based on the septocutaneous perforators from the thoracodorsal artery.
In this article, we introduce a direct cutaneous perforator derived from the lateral
thoracic artery, which provides another option for harvesting a perforator flap from
the lateral thoracic region.
Patients and Methods Overall 17 patients underwent reconstructions using the lateral thoracic perforator
flap for defects resulting from tumor-ablative surgery in the head and neck region,
chronic osteomyelitis, and trauma or chronic wounds of the lower extremities.
Results All flaps survived without major complications and six of the flaps were harvested
in a chimeric pattern.
Conclusion When the latissimus dorsi and thoracodorsal perforator flaps are not suitable, the
lateral thoracic perforator flap provides another option from the lateral thoracic
region that is useful for a variety of reconstructions. However, anatomic variation
and the shorter and smaller pedicle compared with the thoracodorsal vessels are drawbacks
of the lateral thoracic perforator flap that make it difficult to approach. The combination
of the versatility of the previous two perforator flaps based on the thoracodorsal
system and this additional type of lateral thoracic perforator flap makes the lateral
thoracic region a universal donor site.
Keywords
free tissue flaps - perforator flap - thoracic arteries
