Non-Invasive Imaging of Preoperative Mapping of Superficial Veins in Free Flap Breast Reconstruction

119 adduction, and internal rotation of the shoulder joint, it does not function independently. Since it moves in synchrony with a number of synergistic shoulder girdle muscles, the LD muscle can be sacrificed safely without affecting shoulder or arm action [5]. A major surgical advantage of using the LD muscle flap in the field of thoracic surgery is the fact that, because it is an extrathoracic muscle, ipsilateral lung surgery can be performed while simultaneously obtaining the LD muscle through a single posterolateral thoracotomy incision. Furthermore, due to its large bulk and long vascular pedicle, the LD muscle flap can move in apical or mid-thoracic dead space easily with minimal tension, obliterating the pleural space. However, because a LD flap based on the thoracodorsal artery can be short, alternative flaps (e.g., a rectus abdominis flap) should be considered for movement to the lower, supra-diaphragmatic recess of the pleural space. Various flaps can also be used depending on the location of the dead space, such as a serratus anterior flap for the upper region of the thorax and a pectoralis flap or a trapezius flap for the apical region. Tuberculous empyema is uncommon and, unlike other types of empyema, difficult to treat. We performed a lobectomy and used the intrathoracic transposition of a LD muscle flap into the resulting cavity to treat a tuberculous empyema patient who had not improved from the administration of antituberculosis drugs and chest tube drainage. This operation was relatively easy and the patient had no recurrence of empyema or other complications.