Free Composite Latissimus Dorsi Muscle-Rib Flap Not Containing the Intercostal Artery and Vein for Reconstruction of Bone and Soft-Tissue Defects

Ohsumi, Noboru; Shimamoto, Ryoko; Tsukagoshi, Taku

doi:10.1097/00006534-199408000-00026

Cited by 7 publications

(8 citation statements)

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“…37 The periosteal blood supply allows the harvesting of ribs not only together with SA muscle but also with the LD muscle, if the lower ribs are used. 24 Moreover, the intercostals arteries send some muscular and musculocutaneous perforators through LD muscle, what explains the possibility of harvesting also upper ribs as part of a composite LD-R flap. The difference in harvesting this flap, if compare with the SA-R flap in which is mandatory to keep the musculoperiosteal connections, is the need to identify and to isolate the perforator, which provides the blood supply of the choused rib.…”

Section: Discussionmentioning

confidence: 99%

“…22 Despite some publications, which considered the vascularized rib as not suitable in long bones reconstruction, and especially in lower limb, 1,6,16,23,24 we continued to use both the serratus anterior-rib flaps (SA-R) and latissimus dorsi-rib (LD-R) flaps in such reconstructions with a big degree of satisfaction. In this report, we present not only the long-term results of some of the cases discussed in some of our previous articles 21,22 but also the results of the cases treated in the last 6 years.…”

Section: 14-21mentioning

confidence: 99%

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Long‐term results after muscle‐rib flap transfer for reconstruction of composite limb defects

et al. 2011

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The authors present the long-term results in a series of 44 cases with post-traumatic bone defects solved with muscle-rib flaps, between March 1997 and December 2007. In these cases, we performed 21 serratus anterior-rib flaps (SA-R), 10 latissimus dorsi-rib flaps (LD-R), and 13 LD-SA-R. The flaps were used in upper limb in 18 cases and in lower limb in 26 cases. With an overall immediate success rate of 95.4% (42 of 44 cases) and a primary bone union rate of 97.7% (43 of 44 cases), and despite the few partisans of this method, we consider that this procedure still remains very usefully for small and medium bone defects accompanied by large soft tissue defects.

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Section: Discussionmentioning

confidence: 99%

Section: 14-21mentioning

confidence: 99%

Long‐term results after muscle‐rib flap transfer for reconstruction of composite limb defects

et al. 2011

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“…The missing bony support needs to be addressed and in irradiated, infected, or otherwise traumatized tissue, it is preferable to provide vascularized bone for support to decrease the chances of infection and failure of the reconstruction. 1,15,18 In two of our cases, the patients had prior reconstruction with synthetic material or nonvascularized bone graft. Due to the compromise of the local tissue, those reconstructions ultimately became infected and failed.…”

Section: Discussionmentioning

confidence: 93%

Latissimus Dorsi/Rib Intercostal Perforator Myo-Osseocutaneous Free Flap Reconstruction in Composite Defects of the Scalp: Case Series and Review of Literature

Seitz

Adler

Odessey

et al. 2009

J reconstr Microsurg

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Adequate coverage of complex, composite scalp defects in previously radiated, infected, or otherwise compromised tissue represents a challenge in reconstructive surgery. To provide wound closure with bony protection to the brain, improve cranial contour, and prevent or seal cerebrospinal fluid (CSF) leaks, composite free tissue transfer is a reliable and safe option. We report our experience with the latissimus dorsi/rib intercostal perforator myo-osseocutaneous free flap in the reconstruction of bony and soft tissue defects of the cranium and overlying scalp. The surgical technique, design, and outcomes of the latissimus dorsi/rib intercostal perforator myo-osseocutaneous free flap reconstruction in five patients with cranial defects between 2003 and 2007 were retrospectively evaluated. Patient characteristics, defect size, underlying cause, reconstructive details, and complications were analyzed. All patients (age 43 to 81) had composite defects ranging from 36 to 750 cm2 (mean size 230 cm2) for the bony component and from 16 to 400 cm2 (mean size 170 cm2) for the soft tissue defect. All patients had a history of prior or current infection of the affected area, and two patients had a CSF leak. Defects were due to malignancy and infection (n = 2), infiltrative cutaneous mucormycosis with osteomyelitis (n = 1), and hemorrhagic stroke requiring craniectomy (n = 2), complicated by infection and failed cranioplasty in one patient and continuous CSF leak in the other. The latissimus dorsi composite free flap consisting of skin, muscle, and vascularized rib can successfully cover large complex cranial defects, provide skeletal support, improve contour, and significantly enhance functional outcome with limited donor site morbidity.

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“…After the first description of this flap in a dog model, several authors have reported successful results in scalp reconstruction with rib‐muscle composite flaps and so far, 22 cases have been reported with a union rate of 100% . Although these promising results, clinical application of this approach has not been done extensively, given the reported risk of complications related to thoracotomy while harvesting ribs …”

Section: Discussionmentioning

confidence: 99%

“…F, Postoperative clinical picture (2 years follow-up), showing a satisfactory functional and aesthetic result. LDSA-R, latissimus dorsi+serratus anterior-rib free flap [Color figure can be viewed at wileyonlinelibrary.com]extensively, given the reported risk of complications related to thoracotomy while harvesting ribs 26.…”

mentioning

confidence: 99%

The versatility of the thoracodorsal artery based composite flaps with vascularized rib and a systematic review of the literature

Taranto

Amorosi

Sitpahul

et al. 2019

Journal of Surgical Oncology

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Pedicled and free composite flaps derived from the thoracodorsal artery system, including the latissimus dorsi‐rib (LD‐R) and the serratus anterior‐rib (SA‐R) osteo‐muscular or osteo‐myocutaneous flaps, are potential options to address head and neck, thorax, upper and lower extremity bone, and soft tissue defects' reconstruction. We aimed to report our series of LD/SA‐R composite pedicled and free flaps, evaluating outcomes and complications, and to systematically identify all literature reporting results following LD/SA‐rib reconstructions.

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Free Composite Latissimus Dorsi Muscle-Rib Flap Not Containing the Intercostal Artery and Vein for Reconstruction of Bone and Soft-Tissue Defects

Cited by 7 publications

References 0 publications

Long‐term results after muscle‐rib flap transfer for reconstruction of composite limb defects

Long‐term results after muscle‐rib flap transfer for reconstruction of composite limb defects

Latissimus Dorsi/Rib Intercostal Perforator Myo-Osseocutaneous Free Flap Reconstruction in Composite Defects of the Scalp: Case Series and Review of Literature

The versatility of the thoracodorsal artery based composite flaps with vascularized rib and a systematic review of the literature

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