PMC9116235_01
(A) The defect after debridement. (B) Flap design. The blue dot marks the perforator identified with the handled doppler probe.
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A portable Doppler probe was used to identify an intercostal artery perforator in the 6th intercostal space; a tear-shape flap was centred on this vessel, with the upper margin of the flap coinciding with the lower margin of the defect (Figure 1).
Flap raising. After perforator identification, incision of the lower margin and flap raising (A). (B) De-epithelialization and transposition of the proximal portion of the flap. (C) The wound 1 week post-op.
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Tisseel (Baxter Healthcare Corp., Deerfield, IL) was applied to promote flap adhesion to the surrounding tissue and further reduce dead space (Figure 2(A-C)). The wound was closed by bringing the upper margin of the flap to the upper margin of the defect (Figure 3).
At one month post-op the flap was completely consolidated with the thoracic tissues, scars were well healed and no distortion of the thoracic surface was noted.
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Tisseel (Baxter Healthcare Corp., Deerfield, IL) was applied to promote flap adhesion to the surrounding tissue and further reduce dead space (Figure 2(A-C)). The wound was closed by bringing the upper margin of the flap to the upper margin of the defect (Figure 3).
A CT scan executed 1 month post-op (A) and 1 year post-op (B) clearly shows the trophism of the flap (red arrow) and no collection.
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At the last clinical and CT control (June 2019) the flap was completely consolidated with the thoracic tissues, scars were well healed and no distortion of the thoracic surface was noted (Figure 4(A,B)).