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J Plast Reconstr Aesthet Surg. 2013 Dec;66(12):1766-9. doi: 10.1016/j.bjps.2013.04.001. Epub 2013 May 11.

Bilateral pre-expanded free TFL flaps for reconstruction of severe thoracic scar contractures in an 8-year-old girl.

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  • 1Department of Plastic and Hand Surgery, University Hospital of Erlangen, Friedrich-Alexander-University of Erlangen-Nürnberg, Krankenhausstr. 12, 91054 Erlangen, Germany. Electronic address:


We present the case of an 8-year-old girl who suffered from acute myeloid leukaemia-related necrotising fasciitis in her early childhood resulting in severe skin and soft-tissue loss with subsequent circumferential thoracic scar formation. While tissue expander use yielded successful skin replacement for median scar areas, ribs were covered with ultrathin skin envelope at the lateral thoracic wall leading to growth and shoulder abduction impairment. Skin and soft-tissue reconstruction of these extended rib areas was aimed for in a one-step approach. Both lateral thoracic walls were successfully reconstructed with free microsurgical transfer of large pre-expanded tensor fasciae latae flaps, in order to enable future thoracic growth.

Copyright © 2013 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.


Free TFL flap; Free flap in children; Pre-expanded TFL flap

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