Refined harvest technique for a segmental latissimus dorsi muscle flap with a lengthened pedicle

Abstract

The latissimus dorsi (LD) muscle flap is one of the most versatile flaps used for reconstruction of soft tissue defects. With knowledge of its anatomy, harvest of the segmental LD muscle has been introduced as a reliable technique with the advantage of muscle preservation. We devised a new harvest technique for the segmental LD flap using a limited transverse incision to elevate a less bulky distal segment of the muscle with a sufficient pedicle length obtained by intramuscular dissection of the vascular pedicle. Two cases, in which this technique was effectively applied to reconstruct plantar defects after wide excision of malignant melanoma with a maximally efficient use of donor and recipient tissues, are presented. Satisfactory results were gained with stability in walking. When the defect size permits use of a segmental muscle and the long pedicle is needed, this pedicle-lengthened segmental LD muscle harvest technique would be a valuable method.

Reliability of eccentric position of the pedicle instead of central position in a thoracodorsal artery perforator flap

“…Many efforts to extend the vascular pedicle have been described . The recently developed perforator flaps generally have longer vascular pedicles than conventional flaps due to intramuscular dissection .…”

The usefulness of microsurgical pedicle lengthening in free anterolateral thigh flaps

“…Various methods have been introduced to achieve longer pedicles in flap surgery, including lateral arm, gracilis, and latissimus dorsi muscle flaps . A similar pedicle‐lengthening method has been described for TDAP flaps .…”