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Yun-Ta Tsai, MD, Chien-Chang Chen, MD, Hung-I

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1 Free Anterolateral Thigh Combined Flap for Chronic Postpneumonectomy Empyema 
Yun-Ta Tsai, MD, Chien-Chang Chen, MD, Hung-I. Lu, MD, Ming-Jang Hsieh, MD, Michelle Huang, MD, Yur-Ren Kuo, MD, PhD  The Annals of Thoracic Surgery  Volume 90, Issue 2, Pages (August 2010) DOI: /j.athoracsur Copyright © 2010 The Society of Thoracic Surgeons Terms and Conditions

2 Fig 1 (A) Preoperative chest roentgenogram reveals a large empyema in the left chest of a 66-year-old man with a history of pulmonary aspergilloma who underwent left pneumonectomy. (B) An anterolateral thigh composite flap of vastus lateralis (VL) and rectus femoris (RF) muscles (surface area, 28 × 18 cm2) was used to obliterate a 400-mL dead space. The flap pedicle was supplied by the lateral circumflex femoral artery (arrow). (C) Muscle viability was monitored with a 12- × 5-cm2 skin paddle (arrowhead), supplied by the perforator of the lateral circumflex femoral artery. The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2010 The Society of Thoracic Surgeons Terms and Conditions

3 Fig 2 (A) An anterolateral thigh (ALT) combined flap of vastus lateralis (VL) and rectus femoris (RF) muscles was designed for a 70-year-old man with a history of tuberculosis who presented with recurrent empyema after pneumonectomy, as demonstrated in the (B) the chest roentgenogram which shows a large cavity in the left chest. (C) Computed tomography imaging after evacuation of the empyema and closure of the left main bronchus fistula revealed successful insertion of the combined flap (arrow) into the empyema space; however, mild residual empyema developed at 8 months. The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2010 The Society of Thoracic Surgeons Terms and Conditions

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