[Purpose] Although there are reports of many methods of full-thickness chest wall reconstruction, it remains still challenging. For full-thickness chest wall reconstruction, not only soft tissue coverage but also skeletal support must be considered. As material for skeletal support of the chest wall, various materials can be selected. In specific situation, fascia lata provides rigid support. This study reviews reconstructions using free thigh flaps with rigid vascularaized fascia lata to cover full-thickness defects of the chest wall caused by oncological resections.
[Materials and Methods] 35 patients underwent reconstructions of the full-thickness chest wall defects last 10 years using pedicled and free flaps. In 9 of these patients, pedicled myocutaneous flaps can not be available or inappropriate for reconstruction in the case of the entire upper chest wall defect or extensive lateral chest to back defect including latissimus dorsi muscle area; the free thigh flaps with rigid vascularaized fascia lata were selected. All 9 cases had malignant invasive or primary chest wall tumors and underwent wide full-thickness chest wall resections. The flaps which were used for reconstruction, were 7 free anterolateral thigh flaps and 2 free combined tensor fasciae latea flap and free anterolateral thigh flaps.
[Results] No flaps were lost. No respiratory complication occurred. Sufficient chest wall stability was obtained. Donor site morbidity was less even when the skin grafting was needed.

[Conclusion] Free thigh flap (anterolateral thigh flap and/or tensor fasciae latae myocutaneous flap) with rigid vascularized fascia successfully can be used in reconstruction for large full-thickness chest wall defects.