{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T08:58:42Z","timestamp":1790585922052,"version":"4.1.0"},"reference-count":17,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T00:00:00Z","timestamp":1787184000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T00:00:00Z","timestamp":1787184000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Microsurgery"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Radical resection of posterior chest wall sarcomas may result in extensive composite defects exposing lung parenchyma, prosthetic material, and spinal instrumentation, while simultaneously exhausting standard pedicled reconstructive options. Salvage reconstruction after free\u2010flap failure in this setting remains particularly challenging and poorly described. We report the case of a 58\u2010year\u2010old patient who underwent en bloc resection of a large posterior chondrosarcoma involving ribs 6\u201311 and adjacent hemivertebrae, resulting in a massive full\u2010thickness posterior thoracic defect reconstructed with PTFE mesh and spinal instrumentation. Initial soft\u2010tissue coverage using a contralateral free latissimus dorsi and serratus anterior flap failed because of early arterial and venous thrombosis. Salvage reconstruction was subsequently performed using bilateral deep inferior epigastric perforator (DIEP) flaps supplied through a Y\u2010configured saphenous vein graft anastomosed to the thoracodorsal system. The bilateral DIEP flaps provided sufficient surface area and pedicle length extension to achieve tension\u2010free coverage of the near\u2010total posterior hemithorax defect. The salvage procedure lasted 10\u2009h in total. Both flaps survived completely without further vascular complications, allowing timely adjuvant radiotherapy. At one\u2010year follow\u2010up, the patient demonstrated durable soft\u2010tissue coverage without reconstruction failure or local recurrence (Figure\u00a03B,C). This case highlights bilateral DIEP flaps combined with Y\u2010configured vein\u2010graft extension as a feasible salvage strategy for extensive posterior chest wall defects when conventional latissimus\u2010based reconstructive options are unavailable or have failed.<\/jats:p>","DOI":"10.1002\/micr.70284","type":"journal-article","created":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T13:00:42Z","timestamp":1787230842000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Complex Posterior Chest Wall Reconstruction Using Bilateral Deep Inferior Epigastric Perforator Flaps After Failed Latissimus Dorsi Free Flap: A Case Report"],"prefix":"10.1002","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-2256-5682","authenticated-orcid":false,"given":"L\u00e9a","family":"Dibiase","sequence":"first","affiliation":[{"name":"Doctor at Plastic Surgery Department Hautepierre Hospital  Strasbourg France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laetitia","family":"Ruffenach","sequence":"additional","affiliation":[{"name":"Doctor at Plastic Surgery Department Haguenau Hospital  Haguenau France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierre Emmanuel","family":"Falcoz","sequence":"additional","affiliation":[{"name":"Head of Cardio\u2010Thoracic Surgery Department NHC Hospital  Strasbourg France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yann\u2010Philippe","family":"Charles","sequence":"additional","affiliation":[{"name":"Head of Spinal Surgery Department Hautepierre Hospital  Strasbourg France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierre","family":"Kara","sequence":"additional","affiliation":[{"name":"Doctor at Plastic Surgery Department Hautepierre Hospital  Strasbourg 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