Burn Surgery and ResearchLateral Intercostal Artery Perforator-based Reversed Thoracodorsal Artery Flap for Reconstruction of a Chronic Radiation Ulcer of the Lower Back WallNarushima, Mitsunaga MD; Yamamoto, Takumi MD; Yamamoto, Yusuke MD; Hirai, Rintaro MD; Mihara, Makoto MD; Koshima, Isao MDAuthor Information From the Department of Plastic and Reconstructive Surgery, Tokyo University School of Medicine, Tokyo, Japan. Received October 20, 2010, and accepted for publication, after revision, January 18, 2011. Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (www.annalsplasticsurgery.com). Conflicts of interest and sources of funding: none declared. Reprints: Narushima Mitsunaga, MD, Department of Plastic and Reconstructive Surgery, Tokyo University School of Medicine, 7–3-1 Hongo, Bunkyo-ku, Tokyo, Japan 113–0033. E-mail: email@example.com. Annals of Plastic Surgery: October 2011 - Volume 67 - Issue 4 - p 352-356 doi: 10.1097/SAP.0b013e3182115126 Buy SDC Metrics AbstractIn Brief Flaps with adequate blood supply are the best methods for covering the radiation ulcer defect. Our report is on the use of the lateral intercostal artery perforator-based reversed thoracodorsal artery (TA) flap for treatment of a patient with a large radiation ulcer on his lower back. When the flap was elevated, we could use an infrared imaging device to confirm the location of the perforators and demonstrate the communication with the TA. The communication between the main TA and the lateral intercostal artery perforator has previously not been reported in the literature in detail. We used an indocyanine green dye and infrared imaging device to seek out the perforators and their communication. Even in a small communication, we were able to use the device to check the perforators and to elevate this flap with more assurance, without having to be concerned about further radiation exposure for the patient. SUPPLEMENTAL DIGITAL CONTENT IS AVAILABLE IN THE TEXT. © 2011 Lippincott Williams & Wilkins, Inc.