Evolution of Trunk Reconstruction

For practical purposes, the trunk can be divided anatomically into the anterior chest and the back, the latter better termed the posterior trunk, as these two regions in common encompass the thoracic cavity. Their primary responsibility is the maintenance of respiratory function, which must be minimally compromised by any reconstructive maneuvers that would be considered. In addition, in the posterior trunk, the spinal column must be protected so that neurological capabilities are retained intact. Most often, only external coverage is necessary which can best be accomplished by the transposition of vascularized flaps. No shortage of relatively simple pedicled flap alternatives are available, whose attributes as well as detriments need to be well understood. Always remember that every muscle has a function, even if just as a secondary or accessory means for respiration. A perforator flap may then become a preferable choice. Both regions can be arbitrarily broken down into anatomical subunits that serve as a guide to inherent flap selection, whether it be a muscle or perforator flap. The best course of action must always be individualized for the given patient, and that will depend on the unique extent of their defect, tissue requirements, and then careful scrutiny of potential possibilities.