The intercostal muscles, serratus anterior, pectoralis major, and latissimus dorsi, are established workhorse flaps used in most chest wall reconstructions. These flaps are reliable and simple. Less frequently, alternative pedicle flaps may be used: rectus abdominis, fat, or musculocutaneous flaps, so a simple overview may be warranted. Rectus abdominis The rectus abdominis are thick, triangular muscles that extend from the pubic tubercle and arch of the pelvis, to the xiphoid process of the sternum and cartilage from the fifth to seventh ribs. The use of this flap is based on the ease of dissection and the wide rotation arc of the rectus abdominis muscle. The muscle enters the chest through a tunnel under the skin or through the diaphragm. The length and mass of a pedicled rectus abdominis flap can reach, obliterate, and infect the plural space up to the sternal notch. Intrathoracic mobilization is possible on the basis of the superior epigastric vessels, which continue the internal thoracic ones. Unfortunately, the rectus abdominis muscle, as the omental flap would result in a separate abdominal wound. Additionally, its use may result in hernia formation or substantial abdominal wall deformity in thin or malnourished patients.8 Omentum The greater omentum has many properties that make it valuable in chest wall reconstruction. This organ not only has a potential ability to revascularize the organs to which it is attached, but is also rich in macrophages and localizes the infection, even in a heterotopic environment. 18,31The flexibility and bulkiness of the fabric make it suitable for filling irregular spaces and reaching relatively inaccessible places. The omentum flap is movable and large enough to fill a large wound cavity… in the center of the paper… a band of tissue representing the skin portion of the flap. ) of the soft tissue component in muscle flaps is similar to that of other muscle structures. 3 Increased muscle mass, areas of increased enhancement, or 18-FDG fluoride uptake are of concern for recurrence of cancer or infection in the flap.27 However, heavily calcified intercostal muscle flap may show fluoride uptake 18-fluorodeoxyglucose (FDG) similar to that in bone, mimicking a recurrent malignant neoplasm.3 15FLAP COMPLICATIONSIn successful closure of intrathoracic defects, the inflammatory process gradually decreases. The pleura is pulled towards the chest wall and the remaining lung expands.29 There is a risk of partial cavity recurrence when severe destruction caused by fibrosis and adhesions prevents the surrounding lung from expanding.11