Double Antero-lateral Thigh Flow-Through Free Flaps in Series Connection to Reconstruct a Huge Defect in Back

Abstract

Soft tissue sarcomas can occur anywhere in the body. In the back, they pose a significant problem due to their large size. Surgery is the main stay of treatment for soft tissue sarcoma management. However, removal of such tumors results in large soft tissue defects. Skin grafts can resurface large defects, but skin grafts have their own limitations and can delay initiation of radiotherapy. Providing a stable soft tissue cover which can withstand post-op radiotherapy is desirable. Single flap cannot cover large defects. We report one such technique where two antero-lateral thigh free flaps were connected in series for the first time as “chain flaps” for large defect coverage. Six months follow-up showed no complications following radiotherapy. We recommend this technique to cover large size defects which are not amenable to cover via single flap, for optimal outcome.