Double Skin Paddle Latissimus Dorsi Flap Cover for Large Complex Thoracic Wall Defect: A Case Report

Reconstruction of complex chest wall defects is often challenging for plastic surgeons as it demands both framework repair and stable soft tissue cover to protect internal organs. There are many synthetic and autologous options for skeletal reconstruction, and latissimus dorsi (LD) is the workhorse flap for soft tissue reconstruction. However, for larger chest wall defects, the availability of a skin paddle in the LD flap is a problem. Multiple modifications of skin harvest methods have been reported to overcome this problem. One of them is the kiss flap or double skin paddle technique, which is widely reported in the reconstruction of breasts, but has limited evidence of its use in chest wall defects. We present a case of composite anterior chest wall defect, which is covered by polypropylene mesh and a double skin paddle LD flap.