Use of lateral intercostal artery perforator free flaps for resurfacing lower extremities.

Although latissimus dorsi perforator flaps vary less than flaps from other regions, we have encountered several cases where reliable perforator arteries were absent and we harvested lateral intercostal artery perforator (LICAP) flaps instead.Since April 2002, we have attempted to use 97 latissimus dorsi perforator flaps to reconstruct lower extremity defects. In 4 cases, no adequate latissimus dorsi perforators were present, and in 3 cases, the perforators were too small. In all these 7 cases, LICAP were found to be more reliable. The mean pedicle length was 5.4 cm, and the average perforator diameter was 0.8 mm. There were no surgical complications.In this article, we describe these 7 examples of foot and ankle resurfacing using LICAP flaps. Lateral intercostal artery perforator flaps may be an alternative in reconstructive surgery of the foot and ankle region when reliable perforators cannot be found in the lateral thoracic region.