CC BY 4.0 · Arch Plast Surg 2023; 50(03): 233-239
DOI: 10.1055/a-2058-7927
Original Article

Clinical Applications of the Intercostal Artery Perforator Flap for Trunk Reconstruction

1   Department of Plastic Reconstructive Surgery, Chosun University College of Medicine, Gwang-ju, South Korea
1   Department of Plastic Reconstructive Surgery, Chosun University College of Medicine, Gwang-ju, South Korea
1   Department of Plastic Reconstructive Surgery, Chosun University College of Medicine, Gwang-ju, South Korea
1   Department of Plastic Reconstructive Surgery, Chosun University College of Medicine, Gwang-ju, South Korea
› Institutsangaben


Background Trunk defects can occur because of surgical site infections after spinal surgery, resection of malignant tumors, or trauma. Herein, we present our experience of using intercostal artery perforator (ICAP) flaps to reconstruct trunk defects without noteworthy complications. Fourteen patients underwent reconstruction with ICAP flaps between March 2015 and March 2019.

Methods Patients' data, including age, sex, the cause of the defect, defect size, perforator location, flap size, complications, and follow-up period, were retrospectively reviewed. The mean age of the patients was 56.5 years (range, 19–80 years). All operations were performed after the results of bacterial culture from the wound showed no microbial growth. We found reliable perforators around the defect using Doppler ultrasonography. The perforator flaps were elevated with a pulsatile perforator and rotated in a propeller fashion to the defects. We performed five dorsal and two lateral ICAP flaps. The mean flap dimensions were 12 × 5.5 cm2 (range, 6 × 5 to 18 × 8 cm2).

Results Primary closure of the donor site was performed. Marginal congestion was observed as a complication in one case, but it healed with no need for revision. The mean follow-up period was 8 months. All patients were satisfied with the surgical outcomes.

Conclusion ICAP flaps can be easily mobilized, thereby reducing donor site morbidity without sacrificing the underlying muscles for trunk reconstruction. Therefore, these flaps are useful options for the reconstruction of trunk defects.

Authors Contributions

Conceptualization: W.Y.C.

Data curation: Y.J.K.

Writing original draft: Y.J.K.

Writing - review & editing: W.Y.C., J.S.C., and M.H.C.

All authors read and approved the final manuscript.

Ethical Approval

The study was approved by the Institutional Review Board of Chosun University Hospital (approval number: 2020-06-009), and written informed consent was obtained from all patients for participation and publication of their data.


Eingereicht: 02. November 2022

Angenommen: 03. März 2023

Accepted Manuscript online:
21. März 2023

Artikel online veröffentlicht:
29. Mai 2023

© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (

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