The thinned latissimus dorsi free flap: a case report

Full-Thickness Skin Graft as a One-Stage Debulking Procedure after Free Flap Reconstruction for the Lower Leg

“…However, the limited flap size is a shortcoming, especially when confronted with a large skin defect. [1][2][3][4][5][6] The fascia flap with a splitthickness skin graft may also provide thin skin Plastic and Reconstructive Surgery • August 2006 coverage, but limited flap size and discoloration are possible disadvantages and are aesthetically unacceptable. [12][13][14] In our series, the skin defects ranged from 10 ϫ 5 cm to 35 ϫ 8 cm in size.…”

“…[1][2][3][4][5][6] However, the size of the thinned flap is a limiting factor when a larger flap is required for coverage of a large defect due to circulation compromise of a distal area. In addition, skin flaps can undergo necrosis, and although the thin flap can be trimmed to a thickness of 3 to 4 mm, it still looks bulky if it is placed on the pretibial area, ankle, or foot.…”

The Reconstruction of Foot Soft Tissue Defects by Tangential Debulking of the Latissimus Dorsi Flap

“…8 The debulking of an LDM flap by means of tangential trimming was first reported by Rowsell et al in 1986. 9 They performed tangential trimming, so-called ''sculpting,'' intraoperatively after transferring a free LDM flap to cover a forehead scalp deficit. Then in 1992, Chowdary and Murphy reported late sculpting (after 6 months) of six free LDM flaps.…”

“…We tangentially trimmed the flap, leaving a very thin muscle layer at the dorsum of foot, in our debulking and reshaping procedure, which we based on the reports of Rowsell et al and of Chowdary and Murphy. 9,10 The trimmed muscle tissue on the plantar surface was thick, and we created a smooth contour in line with the surrounding skin. During surgery, we found that the muscle tissues were fixed firmly to the underlying bed, and after tourniquet release, we observed spotty bleeding throughout the flap tissue.…”

Free Adipofascial Flap for Scalp Reconstruction: Case Report

“…In particular, latissimus dorsi musculocutaneous flaps 1 " 2 and muscle flaps covered with a split-thickness skin graft 3 - 5 have commonly been used because of their reliability. Modifications that improve recipient-site contour by decreasing the bulk of the latissimus dorsi muscle flap have been introduced, 6 although morbidity at the donor site has also been reported. 7 In this paper, we report a case in which a free scapular and parascapular adipofascial flap, covered with a split-thickness skin graft, was used to reconstruct a large scalp defect, without the sacrifice of major muscles.…”