Surgical flaps in the chest: anatomic considerations, applications, and radiologic appearance.

Abstract

To determine the frequency of use of surgical flaps--tissue that is transposed from its normal location to promote healing and prevent complications--in noncardiac thoracic surgery and to demonstrate the typical radiologic appearances of such flaps. The surgical records of 200 patients who underwent thoracotomy or median sternotomy for noncardiac thoracic surgery were reviewed. Postoperative radiologic studies of randomly selected cases were also reviewed. A total of 213 surgical flaps were used in these patients, including 80 pericardial fat pad flaps (37.6%), 78 greater omental flaps (36.6%), 21 intercostal muscle flaps (9.9%), 16 anterior serratus muscle flaps (7.5%), and 18 greater pectoral muscle, latissimus dorsi muscle, pleural, thymic, or mediastinal fat flaps (8.5%). The flaps produced unusual opacity or attenuation and/or contour of the mediastinum, hilum, or chest wall. Knowledge of common thoracic surgical flaps is helpful in interpretation of postoperative radiologic studies.