Reconstruction of complex intrathoracic tissue defect by free musculocutaneous LD flap - A case report

We present a 51 years-old male who, had right pneumonectomy because of bronchial cancer complicated with broncho-pleural fistula and emphyema. Due to these complications the patient underwent 6 surgical procedures. The broncho-pleural fistula was finally closed after the second transposition of pedicled muscle flap. Extensive scars and deformities of the right side of the thorax made it impossible to fill the dead space and to close die "window" in the chest wall by local flaps. In such circumstances we successfully transfer a free musculocutaneous LD flap from the opposite side. The muscular part of the flap filled the dead space of the right pleural cavity and the skin island enabled closure of the "window" in the chest wall. The postoperative period was uneventful and during 18 months of follow-up there was no fistula or cavity recurrence.