Pedicled latissimus dorsi myocutaneous flap in the reconstruction of the head and neck region: Experience with 17 patients

Abstract

Objective:To assess the efficacy of a modified pedicled latissimus dorsi myocutaneous flap (LDMF) in the reconstruction of defects of the head and neck region.Methods:The retrospective analysis of 17 consecutive patients operated between 2010 and 2014 in the Plastic and Reconstructive Surgery Department of a tertiary care center was performed. Among them, four (23.5%) were initially diagnosed with trauma, while 13 (76.5%) had squamous cell carcinoma originating from the head and neck region. Tumor recurrence, necrosis of the free flap, advanced age, presence of a comorbidity, and previous history of radiotherapy were indicators for a pedicled LDMF. The pedicled LDMF technique was performed via the modified subcutaneous tunnel method in all patients. Demographic, clinical, and peroperative data as well as complications in and a survey of our patients were documented.Results:Our series comprised 11 males (64.7%) and six females (35.3%); the average age was 64.29±5.43 (range, 51 to 72) years. Seroma (5/17, 29.4%) and partial flap necrosis (3/17, 17.6%) were the most common complications, while the rate of mortality during the follow-up period was 17.6% (3/17). One patient died during the early postoperative period, while two died during their oncological treatment and followup. No remarkable functional disabilities or restrictions were postoperatively observed.Conclusion:Our results showed that a pedicled LDMF can constitute a safe and effective alternative for the reconstruction of head and neck defects in selected patients. However, further controlled clinical trials on larger series are warranted to precisely unveil the indications, contraindications, and outcomes of a pedicled LDMF.

Keywords

• Latissimus dorsi
• pedicle
• myocutaneous flap
• head and neck
• reconstruction