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The anatomical study was carried out using 40 preserved cadaveric specimens of latissimus dorsi myocutaneous flaps. It included dissections, angiographies and tissue clearing after arterial injection with latex. The results proved that the dominant vascular supply, the thoracodorsal a., has an almost constant pattern of intramuscular distribution. In addition, there are two sets of segmental pedicles, from the intercostal and lumbar vessels, supplying the medial third of the muscle. The accurate localization of the intramuscular distribution of the thoracodorsal a. permitted the proper design of several island flaps with competent vascularity. The designed flaps were successfully applied in 10 cases for reconstruction of breast, axilla, neck and chest wall.

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