The pedicled intercostal neurovascular island skin flap for lumbosacral trunk reconstruction  Matthew C Wong, Keith Allison, Lok Huei Yap, Francis Peart  British Journal of Plastic Surgery  Volume 57, Issue 6, Pages 520-524 (September 2004) DOI: 10.1016/j.bjps.2004.03.002

Figure 1 (A) Patient positioned laterally on table. (B) Skin paddle designed around perforator. (C) Cephalad rib is excised dorsally. (D) Flap is mobilised along its neurovascular stalk (E) Pedicle is tunnelled and flap inset into defect. (F) Donor site. British Journal of Plastic Surgery 2004 57, 520-524DOI: (10.1016/j.bjps.2004.03.002)

Figure 2 (A) Donor site 4 years post-operative. (B) Recipient site (proximal scar from subsequent spinal surgery). British Journal of Plastic Surgery 2004 57, 520-524DOI: (10.1016/j.bjps.2004.03.002)

Figure 3 (A) 2.5 cm CSF-leaking lumbar defect (B) Healed recipient and donor site 3 years post-operative. British Journal of Plastic Surgery 2004 57, 520-524DOI: (10.1016/j.bjps.2004.03.002)

Figure 4 (A) Metalwork visible at base of wound. (B) Radiograph showing spinal metalwork. (C) Flap 9 months post-operative. (D) Donor site 9 months post-operative. British Journal of Plastic Surgery 2004 57, 520-524DOI: (10.1016/j.bjps.2004.03.002)

Figure 5 (A) Defect that needed soft tissue coverage. (B) Flap 6 months post-operative. (C) Donor site hernia. British Journal of Plastic Surgery 2004 57, 520-524DOI: (10.1016/j.bjps.2004.03.002)