The free musculocutaneous tensor fascia lata flap as a backup procedure in tumor surgery

The musculocutaneous tensor fascia lata (TFL) flap provides a small muscle belly and a strong fascial layer in combination with abundant skin coverage (15 x 40 cm), which makes the flap an attractive unit for composite free tissue transfer. The free TFL flap was used in nine cases of recurrent cancer of the chest wall (N = 7) and the abdominal wall (N = 2). The mean size of the full-thickness defects after tumor excision measured 12 x 25 cm. The operating time ranged from 4 to 8 hours (mean operating time, 5.5 hours). The operation was performed with two teams, and no repositioning of the patient was necessary during the operation. By raising the TFL flap, no additional area of the trunk was involved. The authors did not experience a prolonged ventilation time in their group of multimorbid patients. The donor site was closed directly (4 of 9 patients) or split skin grafted (5 of 9 patients). There was no functional deficit. In one patient the venous anastomosis had to be revised. There were no further complications, and no flaps were lost. The hospital stay was short (21 days on average), the outcome successful, and primary healing was obtained. The free TFL flap proved to be a reliable flap that is easy technically to harvest. Thus the free TFL flap is a valuable backup procedure in tumor surgery.