Supermicrosurgical free sensate intercostal artery perforator flap based on the lateral cutaneous branch for plantar reconstruction.

The use of an intercostal artery perforator (ICAP) flap has recently become popular in reconstructive surgery. We have developed a novel free sensate ICAP flap based on the lateral cutaneous branch (LCB) and applied it to a case with a plantar defect. To the best of our knowledge, this case is the first to describe a free sensate ICAP flap based on the LCB. This method has several advantages: (1) a sensate flap is possible because the LCB neurovascular bundle is consistently available; (2) the long neurovascular pedicle can be harvested in the supine position without the risk of pneumothorax; (3) the donor-site morbidity is low; and (4) conversion or combination with a superficial circumflex iliac artery perforator (SCIP) or a superficial inferior epigastric artery (SIEA) flap is readily possible. We believe that this method represents a new option for soft-tissue reconstruction.