Answer:
Problems:
1) indistinct borders of injury
2) limited reconstructive options because of necrosis in the recipient bed and damaged blood vessels in potential donor areas
3) irradiated areas are prone to infection
4) synthetic materials tend to fail
Treatment guidelines:
1) aggressive debridement of all infected and ischemic tissue
2) well vascularized muscle flap coverage without prosthetic mesh if possible
Options include:
1) latissimus dorsi with or without skin
2) TRAM
3) pectoralis major
4) pedicled omentum
5) laterally based random chest flaps