Complex Posterior Chest Wall Reconstruction Using Bilateral Deep Inferior Epigastric Perforator Flaps After Failed Latissimus Dorsi Free Flap: A Case Report.
Léa Dibiase, Laetitia Ruffenach, Pierre Emmanuel Falcoz et al.
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Case in brief
A 58-year-old patient underwent radical resection of a large posterior chondrosarcoma, resulting in a significant thoracic defect. Initial reconstruction with a latissimus dorsi flap failed due to thrombosis. Salvage reconstruction was successfully performed using bilateral deep inferior epigastric perforator flaps with a Y-configured vein graft. The flaps survived completely, allowing for timely adjuvant radiotherapy, and the patient showed no recurrence at one-year follow-up.
What made this case unusual
The use of bilateral DIEP flaps with a Y-configured vein graft for salvage reconstruction after failed latissimus dorsi flap is a notable approach in this complex case.
Diagnostic / clinical pearl
Clinicians should consider bilateral DIEP flaps as a viable option for reconstructing extensive chest wall defects, especially after failure of conventional flap techniques.
Why it matters
This case underscores the importance of innovative reconstructive strategies in managing complex defects, particularly when standard options are exhausted.