The unilateral reverse latissimus dorsi flap for soft tissue coverage of midline thoracal defects after spine surgery procedure: A case report

Abstract

Introduction The thoracolumbal region is often a difficult area to reconstruct for orthopaedic surgeons. Reconstruction of this area with a standard free tissue transfer is not always possible, and locoregional flaps are often failed due to poor quality outcome and mobilization difficulty. Case report A case was presented with unilateral distally based latissimus dorsi flaps reconstruction in patient with midline thoracal soft tissue defect underwent kyphosis deformity correction surgery. This study reported a patient, male, 33 years old who was diagnosed with ankylosing spondylitis and kyphosis deformity. The patient underwent surgical correction of the kyphosis deformity. After 1 month, the patient complained about his open surgical wounds. Clinical discussion In our institution, this patient underwent second debridement surgery and unilateral reverse latissimus dorsi flap for thoracal soft tissue defect coverage to obtain well-vascularised tissue, with good resistance to bacterial contamination and easy to shape into such defect. After follow-up for 6 months, the patient shows good outcome and postoperative wound healing was favorable. Conclusion We believe that the “reverse” latissimus dorsi flap is a good option to cover this particular region. It is simple, safe, and reliable. It also provides a backup plan for the microsurgery in this region.

Prophylactic Muscle Flaps in Patients with Oncologic Spine Disease Decrease Wound Complication Rates: A single institution cohort study

“…Other types of flaps used in the reconstruction of spinal wounds include rotational trapezius flaps for cervical spine reconstruction and latissimus dorsi and gluteus maximus flaps for complex lumbar wounds, all of which offer three-dimensional wound reconstruction in the setting of spine tumor removal. 35,36 The increased blood flow provided by the musculocutaneous flap offers significant advantages in healing. 37 Spine surgery, especially in the case of extensive tumor resection, disrupts the natural vasculature of the soft tissues, increasing the risk of poor healing and infection.…”

“…Other types of flaps used in the reconstruction of spinal wounds include rotational trapezius flaps for cervical spine reconstruction and latissimus dorsi and gluteus maximus flaps for complex lumbar wounds, all of which offer three-dimensional wound reconstruction in the setting of spine tumor removal. 35,36…”