{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T11:20:26Z","timestamp":1780485626897,"version":"3.54.1"},"reference-count":29,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2025,2,18]],"date-time":"2025-02-18T00:00:00Z","timestamp":1739836800000},"content-version":"vor","delay-in-days":17,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Microsurgery"],"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Full thickness thoraco\u2010abdominal defects are traditionally challenging to reconstruct, exposing the patient to a significant risk of wound complications and functional impairment. The authors present an extremely challenging and unique case where a huge lateral thoraco\u2010abdominal defect was reconstructed with a combination of innervated flaps allowing to completely restore contour and function of the operated region. A 77\u2010year\u2010old male patient presented with a leiomyosarcoma arising in the right lateral thoraco\u2010abdominal region. Full\u2010thickness resection involved the anterior part of the latissimus dorsi (LD) and serratus anterior muscles along with IX to XII ribs, a cuff of diaphragm muscle and the entire lateral abdominal wall, creating a 30\u2009\u00d7\u200925\u2009cm defect with exposure of right lung, liver, and ascending and transverse colon. After the placement of a synthetic mesh, a 28\u2009\u00d7\u200916\u2009cm pedicled innervated LD flap was advanced in V\u2010Y fashion to cover the thoracic part of the defect. Then the patient was turned supine and a vastus lateralis free functional muscle transfer (FFMT) from the contralateral thigh was used to reconstruct the abdominal part of the defect. The recipient vessels were provided transposing the ipsilateral deep inferior epigastric pedicle according to the extra\u2010anatomical pedicle rerouting technique. Motor branch for the VL was coapted to a sizeable intercostal nerve. The muscle was covered with split\u2010thickness skin grafts. Both flaps healed uneventfully, allowing to obtain a complete restoration of form and function with M5 score according to the MRC Scale for muscle strength 8\u2009months after surgery. Functional reconstruction of the lateral abdominal wall with FFMT has never been reported. Our successful case shows the importance of functional reconstruction of lateral thoraco\u2010abdominal defects to prevent abdominal weakness or herniation, trunk instability, postural deficiencies and core strength loss.<\/jats:p>","DOI":"10.1002\/micr.70038","type":"journal-article","created":{"date-parts":[[2025,2,19]],"date-time":"2025-02-19T02:11:26Z","timestamp":1739931086000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Functional Reconstruction of a Huge Lateral Thoraco\u2010Abdominal Defect With Combined Innervated Pedicled Latissimus Dorsi Flap and Vastus Lateralis Free Functional Muscle Transfer: A Case Report"],"prefix":"10.1002","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4863-3926","authenticated-orcid":false,"given":"Beniamino","family":"Brunetti","sequence":"first","affiliation":[{"name":"Operative Research Unit of Plastic, Reconstructive and Aesthetic Surgery Fondazione Policlinico Universitario Campus Bio\u2010Medico  Rome Italy"},{"name":"Department of Medicine and Surgery, Research Unit of Plastic, Reconstructive and Aesthetic Surgery Universit\u00e0 Campus Bio\u2010Medico di Roma  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8910-6586","authenticated-orcid":false,"given":"Marco","family":"Morelli Coppola","sequence":"additional","affiliation":[{"name":"Operative Research Unit of Plastic, Reconstructive and Aesthetic Surgery Fondazione Policlinico Universitario Campus Bio\u2010Medico  Rome Italy"},{"name":"Department of Medicine and Surgery, Research Unit of Plastic, Reconstructive and Aesthetic Surgery Universit\u00e0 Campus Bio\u2010Medico di Roma  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fiorella","family":"Oliveri","sequence":"additional","affiliation":[{"name":"Operative Research Unit of Plastic, Reconstructive and Aesthetic Surgery Fondazione 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