case_images: PMC11312377_01
case_images: (A) initial presentation of a 4 x 5 cm defect in the chest wall. (B) Post-excision of necrotic skin and soft tissue, revealing the underlying structural deficit. (C) The resected rib segment exhibiting osteonecrosis. (D) A 10 x 8 cm defect in the chest wall, now stabilized with a synthetic mesh, providing a scaffold for tissue integration. (E) Preparation of a vertically oriented LD myocutaneous flap prior to its transfer. (F) Completion of the reconstruction with a split-thickness skin graft applied to the raw surfaces. LD, latissimus dorsi.
case_images: fsurg-11-1397233-g001.jpg
case_images: PMC11312377_01_fsurg-11-1397233-g001.jpg
case_images: F1
case_images: Follow-up over two months postoperatively revealed no additional complications (Figure 1).
case_images: PMC11312377_02
case_images: (A) presentation of a 15 x 9 cm defect in the chest wall, necessitating complex surgical management. (B) Following excision of the compromised skin and soft tissue, post successful closure of a bronchopleural fistula. (C) Harvesting of a vertically oriented LD myocutaneous flap in preparation for translocation to the chest wall defect. (D) Subsequent insetting and integration of the flap, providing robust coverage. (E) Immediate postoperative appearance following reconstructive surgery. (F) The patient's anterior view four weeks post-surgery, showing satisfactory healing and contour restoration without complications. LD, latissimus dorsi.
case_images: fsurg-11-1397233-g002.jpg
case_images: PMC11312377_02_fsurg-11-1397233-g002.jpg
case_images: F2
case_images: Follow-up at four months postoperatively revealed no additional complications (Figure 2).
case_images: (A) preoperative markings on the patient's chest represent the boundaries of the surgical area, with a dotted line indicating the potential flap design for reconstruction. (B) Retractors are utilized to pull the tissue aside, revealing the lateral border of the LD muscle. A dissection is made beneath this border. (C) The creation of a muscle pedicle and the design of a skin flap positioned over it. The flap has been elevated in preparation for transfer. (D) The initial defect covered by the transferred flap, and the donor site area closed primarily. LD, latissimus dorsi.
case_images: fsurg-11-1397233-g003.jpg
case_images: PMC11312377_02_fsurg-11-1397233-g003.jpg
case_images: F3
case_images: The flap is transferred to the defect via subcutaneous tunneling, and the donor site is closed primarily, or if not possible, with an STSG (Figure 3).