Thirteen patients who underwent 13 latissimus dorsi free flaps for subacute foot dorsum defects were identified over a 4-year period. The average age of the patients was 30.5 years (range: 8 to 52 years). There were eight male, five female patients. The average follow-up was 23 months (range: 2 to 47 months). The soft-tissue defect resulted from motor vehicle accident in all cases. All of the patients presented with soft-tissue loss combined with extensor tendon and/or bone injury. The wounds were treated with serial debridement and free latissimus dorsi or latissimus dorsi-serratus anterior muscle and split-thickness skin graft coverage in all cases. The mean size of the flaps was 19 x 11 cm (range: 15 to 24 cm x 9 to 16 cm). Twelve of 13 flaps survived. Complications included infection (1 case), seroma in the donor region (2 cases), total flap failure (1 case), partial flap necrosis (2 cases), and wound dehiscence (2 cases).

Defects of the chest wall are often encountered, and good results can be obtained both cosmetically and functionally from their treatment. We treated 13 patients with full thickness chest wall defects. Follow up ranged from 12 days to 19 months. Three had had recurrent breast carcinoma, seven relapse after excision of a sarcoma, two had had lesions of the chest wall after irradiation, and one had a sternal fistula. Local skin, musculocutaneous and free latissimus dorsi and anterolateral thigh flaps were done to cover soft tissue. Fascia lata, polypropylene (Marlex) mesh, and Marlex mesh-methylmethacrylate sandwich prosthesis, were used to stabilise the skeleton in nine patients. Two of the patients died postoperatively, one early. The use of Marlex mesh-methylmethacrylate sandwich prostheses for the stabilisation of the skeleton and local musculocutaneous flaps for covering soft tissues after resection of three or more ribs is effective.