Latissimus Dorsi Muscle Flap for Scalp Reconstruction and Postoperative Ulceration Management

Abstract

low flow lesions. Magnetic resonance differentiates the arteriovenous malformation from a hemangioma, and venous or lymphatic malformation. 7 Invasive investigations of venous system (venography) and arterial system (arteriography) are used for treatment planning. Digital subtraction angiography is an essential tool that involves super-selective arteriography which consists of injecting a radiopaque substance into the vascular system through a catheter near the region. In this series 2 patients had CT angiogram and 2 Digital subtraction angiography which helped in diagnosis and surgical planning.Various noninvasive treatment options include super-selective intra-arterial embolization using liquid agents, such as n-butyl-cyanoacrylate, coils, ethanol (absolute alcohol), sodium tetradecyl sulfate, gelfoam, microfibrillar collagen, sclerotherapy which is performed by using sodium morrhuate, boiling water, nitrogen mustard, ethanol (absolute alcohol) or sodium tetradecyl sulphate mixed with a contrast medium (ethiodol or iodinated contrast) under realtime fluoroscopic control, and bone wax packing of bone cavities. 8 In extensive angiomatosis either radiotherapy or interferon a-2a treatment are used. 6 In localized cases, complete resection is preferred but there is a risk of local recurrence. Curettage of the resected fragment with immediate reimplantation does, however, reduce the morbidity associated with the procedure and the difficulty of reconstruction. 8,9 The ligation of the external carotid is widely cited as an adjunct to many approaches. Partial excision or linking of the feeder artery may set off lesion growth and considerably worsen the prognosis. In this series 4 cases had control over the ECA and selective ligation of vessels. All the cases in this series had wide excision with reconstruction with each case being unique in its nature and challenges. (Supplementary Digital Content, Table 1, http://links.lww.com/SCS/C967) Case series notifies the gigantic presentation of Angiomatosis of the jaws which are the rarest benign tumors occurring in the maxillofacial region. Proper diagnosis is very important to avoid mishaps in management and a more cautious approach like airway control, intraoperative bleeding in huge lesions as shown in this case series is required to treat massive lesions. It is a surgical challenge for reconstruction and rehabilitation of these patients postoperatively. Clinical assessment and precise diagnosis remain the cornerstone of the successful management of vascular lesions.

Successful repair of an encephalocele wound in a child following a car accident: A case report

“…Upton and Guo ( 14) used muscle combined with an STSG when covering injuries in children with trauma and infected wounds. Due to its extensive coverage, thin thickness, flexibility and minimal donor area injury, the LDMF combined with skin graft is considered the best choice for subtotal or total scalp reconstruction (16,17).…”

Reviving Cranial Outer Table Perforations as a Modern Innovation for Complex Scalp Avulsion Injuries Reconstruction: A Case Report

“…Knowledge of vascular anatomy is essential for selecting the appropriate recipient vessels for successful free flap. Free flaps that have been used in scalp reconstruction include latissimus dorsi (LD) free flap as the most frequently used flap in scalp reconstruction, rectus abdominis free flap, radial forearm, anterolateral thigh (ALT), omentum, subscapularis and serratus muscle [10] .…”

“…Latissimus dorsi muscle free flap is widely regarded as optimal choice for total scalp reconstruction, owing to its ability to provide extensive coverage, excellent pliability and a long dependable vascular pedicle, which has made it the most frequently utilized flap [10] . This procedure involves harvesting latissimus dorsi muscle from a patient's back along with a segment of skin and subcutaneous tissue and transplanting it onto the scalp, and as such it requires specialized surgical expertise, as well as careful patient selection, but can achieve highly satisfying results in the hands of experienced surgeons.…”

36-year Follow-up on Scalp Reconstruction Using Free Latissimus Dorsi Muscle Flap, Skin Grafting, and Scalp Expansion

“…Covering the exposed bone and defect with a free muscle flap and skin graft to cover the muscle. 2–6…”

“…Covering the exposed bone and defect with a free muscle flap and skin graft to cover the muscle. [2][3][4][5][6] In this case, option C was chosen. The ideal free flap is the latissimus dorsi muscle because of its large surface area and rather thin thickness.…”