Survival of a pedicled latissimus dorsi flap in breast reconstruction without a thoracodorsal pedicle

Hartmann, Christoph; Branford, Olivier A.; Malhotra, Aseem; Chana, Jagdeep S.

doi:10.1016/j.bjps.2012.11.028

Cited by 3 publications

(4 citation statements)

References 12 publications

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“…Second, the TD vessel harvest may disallow the option of a latissimus dorsi flap later thus potentially sacrificing this “lifeboat” for the future breast reconstruction with a pedicle flap. However, it has been shown that the serratus branch is a reliable vascular supply for the latissimus dorsi flap even when the TD vessels have been damaged . Third, there are some technical considerations of this method.…”

Section: Discussionmentioning

confidence: 99%

Nipple‐sparing mastectomy and breast reconstruction with a deep inferior epigastric perforator flap using thoracodorsal recipient vessels and a low lateral incision

Lin

Pappalardo

et al. 2018

Journal of Surgical Oncology

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Section: Discussionmentioning

confidence: 99%

Nipple‐sparing mastectomy and breast reconstruction with a deep inferior epigastric perforator flap using thoracodorsal recipient vessels and a low lateral incision

Lin

Pappalardo

et al. 2018

Journal of Surgical Oncology

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“…Le pé dicule thoraco-dorsal est en effet proté gé lors de la dissection par le tendon du muscle LD, qui vient passer en avant de son pé dicule lors du transfert en paroi thoracique anté rieur et aprè s section partielle de son tendon telle que nous la ré alisons dans notre é quipe. En cas de plaie vasculaire peropé ratoire du pé dicule thoraco-dorsal, une vascularisation du muscle LD via les anastomoses avec le muscle Serratus est dé crite, voire même via l'artè re thoracique laté ral en cas de lé sion du pé dicule thoracodorsal ainsi que des anastomoses avec le muscle serratus [21], rendant ainsi hautement peu probable une né crose du LGD aprè s son transfert en paroi thoracique anté rieure. En cas d'indication de chimiothé rapie adjuvante suite à l'analyse histologique de la piè ce de mastectomie et du/des ganglion(s) sentinelle(s), nous conseillons sa ré alisation avant la reprise opé ratoire pour CAc.…”

Section: Discussionunclassified

Curage axillaire après reconstruction mammaire par lambeau de grand dorsal : principes chirurgicaux et résultats

Carrabin

Dammacco

Beurrier

et al. 2015

Gynécologie Obstétrique & Fertilité

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“…The latissimus dorsi musculocutaneous flap is a reliable and dependable option and has been used for autologous breast reconstruction since the 1970s. 1,2 With the evolution of muscle sparing methods of breast reconstruction, the pedicled thoracodorsal artery perforator (TDAP) flap has become increasingly popular. In cases where a TDAP flap has failed, reconstruction with the ipsilateral latissimus dorsi musculocutaneous flap is no longer an option because the thoracodorsal artery and vein as well as the cutaneous component have been sacrificed.…”

mentioning

confidence: 99%

“…The flap is based on the thoracodorsal artery and vein and is capable of maintaining perfusion through the serratus branch of the thoracodorsal artery. 1,2 As a free tissue transfer, the latissimus dorsi muscle is usually used as a thin flap for resurfacing regions such as the scalp or lower extremity. Its use as a free flap for breast reconstruction is rare but has been reported.…”

mentioning

confidence: 99%

Tertiary Breast Reconstruction Using a Free Contralateral Latissimus Dorsi Musculocutaneous Flap

Endara

Verma

Nahabedian

2013

J reconstr Microsurg

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The latissimus dorsi musculocutaneous flap is a reliable and dependable option and has been used for autologous breast reconstruction since the 1970s. 1,2 With the evolution of muscle sparing methods of breast reconstruction, the pedicled thoracodorsal artery perforator (TDAP) flap has become increasingly popular. In cases where a TDAP flap has failed, reconstruction with the ipsilateral latissimus dorsi musculocutaneous flap is no longer an option because the thoracodorsal artery and vein as well as the cutaneous component have been sacrificed. Secondary donor sites such as the abdomen, thighs, and buttock are considered and often used; however, in some patients these donor sites are either not suitable or declined. Another option in these situations is to consider the contralateral latissimus dorsi musculocutaneous flap as a free tissue transfer. We describe the use of a free contralateral latissimus dorsi musculocutaneous flap for delayed breast reconstruction following radiation therapy and previous ipsilateral TDAP failure.A 39-year-old woman presented following mastectomy, radiation, and multiple attempts at breast reconstruction all resulting in failure (►Fig. 1). Relevant history included previous bilateral breast augmentation with saline implants placed in a submuscular position 4 years before a diagnosis of stage IIIa invasive ductal breast cancer. The patient had a left mastectomy with immediate reconstruction using a tissue expander and acellular dermal matrix. Six months after completing adjuvant chemotherapy and radiation, she underwent exchange of the tissue expander for a high profile 550 mL round silicone gel breast implant, which was complicated by incisional dehiscence prompting a return to the operating room and exchange of the device for a 450 mL silicone gel implant. The incision again dehisced and the decision was made to perform a pedicled TDAP flap with implant removal. This reconstruction was unsuccessful and resulted in a flap failure. These operations were all performed at another hospital.On initial examination the patient was 5 ft 1 in tall and weighed 118 lb (body mass index 22.3). She had an acquired absence of her left breast with significant contour abnormality and thin skin with radiation damage. She was also noted to have a previously augmented right breast. Her abdomen demonstrated minimal skin and fat, as did the superior gluteal region. Autologous tissue reconstruction options were explained to the patient including a pedicled transverse rectus abdominis myocutaneous (TRAM) flap, free unilateral abdominal flap (deep inferior epigastric perforators vs. muscle sparing-TRAM), superior gluteal artery perforator flap, or a contralateral latissimus dorsi musculocutaneous free flap. She ultimately decided on a free tissue transfer using the contralateral latissimus dorsi musculocutaneous flap.At the time of surgery, the patient was marked in the standing position with her skin paddle oriented along the relaxed skin tension lines. . The internal mammary artery and vein were exposed ...

show abstract

Survival of a pedicled latissimus dorsi flap in breast reconstruction without a thoracodorsal pedicle

Cited by 3 publications

References 12 publications

Nipple‐sparing mastectomy and breast reconstruction with a deep inferior epigastric perforator flap using thoracodorsal recipient vessels and a low lateral incision

Nipple‐sparing mastectomy and breast reconstruction with a deep inferior epigastric perforator flap using thoracodorsal recipient vessels and a low lateral incision

Curage axillaire après reconstruction mammaire par lambeau de grand dorsal : principes chirurgicaux et résultats

Tertiary Breast Reconstruction Using a Free Contralateral Latissimus Dorsi Musculocutaneous Flap

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