The sensate medial dorsal intercostal artery perforator flap as an option for treatment of dorsal cervicothoracic midline defects.

摘要

We read with interest the CME article on chest wall reconstruction by Netscher et al. We agree with the authors that regional reconstruction of the posterior trunk can be challenging because of relative inaccessibility for pedicled flaps, exposure of bone or orthopedic hardware, infection, and loss of function. Traditionally, muscle or musculocutaneous flaps have been used to treat posterior midline defects in the cervicothoracic area. These flaps provide well-vascular-ized tissue for the treatment of infection, to fill dead space, and cover bone and orthopedic hardware. Although perforator flaps have become increasingly popular, the authors mention only the distant musculocutaneous perforator flaps for the treatment of defects in the midline. According to the authors, these flaps require a distinct dissection that even can take a trans-pleural course.