Freestyle perforator puzzle flap for posterior trunk reconstruction

Closure of extensive defects of posterior trunk can be challenging for reconstructive surgeons owing to the need of a large bulk of well-vascularized tissue to resurface the skin and the exposed hardware and to fill the dead spaces. We hypothesized that elevating multiple perforators flaps in various patterns would allow for reconstruction of large posterior trunk defects with tension-free primary closure and minimal donor site morbidity.