Experience with the Latissimus Dorsi Flap

Abstract

A review of 65 applications of the latissimus dorsi flap based on the thoraco-dorsal vessels to recipient sites in the head and neck area (10), on the torso (22), in the upper extremity (9) and in the lower extremity (24) in 62 patients with malignancies (28) and congenital deformities (6) is presented. Thirty-five flaps were transplanted with microsurgical vascular technique, while 30 flaps were pedicled. Vascular thrombosis at the anastomotic site was seen in 4/35 free tissue transplants and was successfully managed in 3 cases with an overall survival rate of 97% in this group, while all pedicled flaps survived. Healing complications including haematomas and wound infections were related to the nature of the recipient site and most commonly seen in the lower leg after resection of infected bone. In 3 cases leg amputations were performed within 6 months after the reconstruction, while 6 patients had secondary operations for tibial pseudoarthroses. Donor site morbidity was insignificant, without permanent, functional losses. It is concluded, that the thoracodorsal unit is a versatile and safe flap for reconstructive purposes.

Reconstruction Following Extensive Tumor Resection of the Pelvic and Scapular Girdle: A Report of Two Cases

“…When there is enough skin, local flaps can be used 3 , 5 , 6 , or a myocutaneous flap from the deltoid (4) . Other proposals for reconstructing these substance losses include use of the pectoralis minor muscle, rotation of the greater omentum, and muscle flaps based on the latissimus dorsi with a homolateral pedicle 19 , 20 , 21 , 22 . These flaps may be limited to the extent of the substance loss and, in some cases, to the needs of the rib cage.…”

Utilização do Músculo Grande Dorsal Contralateral após Amputação Interescápulo-Torácica - Relato de Caso

“…O uso do grande dorsal em toda a sua extensão, inclusive aponeurose, vascularizado pelo pedículo secundário, permitiu o fechamento de toda a área cruenta. A vantagem principal deste retalho deve-se ao seu grande tamanho, facilitando a reparação de grandes áreas cruentas, apresentando menor morbidade em relação ao epíploon, podendo ser utilizado na ressecção concomitante do gradeado costal 2,11 .…”

Reconstrução após ressecção extensa de tumor das cinturas pélvica e escapular: relato de dois casos

“…When there is enough skin, local flaps can be used (3,5,6) , or a myocutaneous flap from the deltoid (4) . Other proposals for reconstructing these substance losses include use of the pectoralis minor muscle, rotation of the greater omentum, and muscle flaps based on the latissimus dorsi with a homolateral pedicle (19)(20)(21)(22) . These flaps may be limited to the extent of the substance loss and, in some cases, to the needs of the rib cage.…”