Lateral intercostal artery perforator-based reverse thoracic flap for antecubital reconstruction

Abstract

Pedicled flaps distant from the trunk are often used to reconstruct defects of the upper extremity. For this, various flaps have been described, with the groin flap being the most common. Recently, perforator flaps and perforator-based pedicled flaps have been described, that can be raised from the trunk for reconstruction of various defects. The lateral intercostal artery perforator (LICAP) flap, raised from the lateral and posterior thorax, has been used for chest reconstruction. Also LICAP flaps from the abdominal area were described in reconstruction of the upper extremity. In this paper we report a case where a LICAP-based thoracic flap was used for the reconstruction of the antecubital area of the upper extremity. This is the first report of the application of this flap to the upper extremity. The advantages of reverse LICAP flap from the posterolateral thoracic area are: (1) no kinking in the pedicle as it is not folded, especially for antecubital defects, (2) hairless skin from the midaxillary line area, (3) thinner flap compared to the abdominal area and (4) the scar is on the back of the patient in a more acceptable area.