Efficient design of a latissimus dorsi musculocutaneous flap to repair large skin defects of the upper back

Abstract

Closing large skin defects of the upper back is a challenging problem. We have developed an efficient design for a latissimus dorsi musculocutaneous flap for reconstruction in this region. The longitudinal axis of the skin island was designed to be perpendicular to the line of least skin tension at the recipient site so that primary closure of the flap donor site changed the shape of the recipient site to one that was easier to close. We used this method for four patients with skin cancers or soft-tissue sarcomas of the upper back in 2011 and 2012. The size of skin defects after wide excision ranged from 11 × 10 to 25 × 20 cm(2) , and all skin defects could be covered by the flaps and all wounds of donor site could be closed without skin grafts. No wound complications occurred in any patient. Functional and aesthetic outcomes were satisfactory in all patients. This flap design is effective for reconstructing large skin defects of the upper back.

Propeller Dorsal Intercostal Artery Perforator Flap for an Extensive Defect on the Back Following Malignant Peripheral Nerve Sheath Tumor Resection: A Case Report

“…Many different operative options have been used to cover the posterior trunk defect; each has distinct advantages and disadvantages. Myocutaneous flaps, such as the latissimus dorsi flap and the trapezius muscle flap, have long been the main treatment for posterior trunk reconstruction [1,2,18,19]. These flaps provide well-vascularized tissue and simple and reliable techniques, but they imply major donor-site morbidity (sacri-gain sufficient pedicle length without tension.…”

“…Posterior trunk defects result from diverse etiologies, such as pressure sores, tumor resection, infection, or trauma, and represent a challenging procedure. Myocutaneous flaps, such as the latissimus dorsi flap or trapezius flap, have been widely used to cover these defects [1][2][3]. Although these flaps are preferred by some authors because of simple and reliable techniques [4], they are associated with greater donor-site morbidity than perforator flaps.…”

Impact of groin flap ischemia-reperfusion on red blood cell micro-rheological parameters in a follow-up study on rats

“…In the reconstructive surgical procedures various pedicled flaps can be used for covering tissue defects [6,17,19,20]. For reconstructive surgery the choice is always depending on the region involved; but the common interest, the most important question of such procedures is the flap survival rate [12,17].…”

Intra and postoperative evaluations of microcirculation and micro-rheological parameters in a rat model of musculocutaneous flap ischemia-reperfusion

“…Reconstruction of large defects on the body requires flap surgeries [1][2][3] . The method of choice for reconstructive surgery is always depending on the region involved; however the common interest of such procedures is the flap survival rate 1,4 .…”