Reconstruction of a dorsal thoracic wall defect with a dorsal intercostal artery perforator flap after removal of a bulky cutaneous squamous cell carcinoma: a case report.

ABSTRACT

INTRODUCTION: Surgical reconstruction of large soft tissue defects of the upper back is challenging. Although the usefulness of free perforator flaps has been demonstrated, local options remain limited. The dorsal intercostal artery perforator flap was recently described but its use is still uncommon. CASE REPORT An 88-year-old Causasian woman presented with a large, ulcerated, left prescapular cutaneous squamous cell carcinoma (T3N0M0). Complete excision was performed, and the resulting defect was reconstructed with a dorsal intercostal artery perforator flap based on two perforators. Postoperative recovery was uncomplicated and adjuvant radiotherapy commenced 10 weeks later. CONCLUSION: Compared to conventional muscle flaps, the dorsal intercostal artery perforator flap offers greater protection of muscle function, is less invasive, and lowers donor site morbidity. Based on these advantages, this flap should be considered a useful local option for reconstructing large cutaneous defects of the upper back.