Local transposition flap repair of the pectoralis major myocutaneous flap donor site.

A local transposition flap can be used to close a large donor defect. This is a medially based transposition flap. Although the flap is randomly patterned in design, there is a rich supply of cutaneous perforators in this region of the trunk. These include anterior perforators from the internal thoracic artery, perforators from the superior and inferior epigastric arcades that can communicate across the midline, the superficial superior epigastric artery (occurs only infrequently), and intercostal perforators. The secondary defect of the transposition flap is closed primarily.2 The transposition flap described is similar in design to the thoracoepigastric flap.3