Use of pedicled latissimus dorsi myocutaneous flap to reconstruct the upper limb with large soft tissue defects

Abstract

【Abstract】 Objective: To report the technique of reconstruction of large skin and soft tissue defects in the upper extremity using pedicled latissimus dorsi myocu-taneous flaps. Methods: Six patients with large skin and soft tissue defects were included in this report. There were 5 trauma patients and the rest one needed to receive plastic surgery for his extremity scar. All wounds were in the upper extremity. The sizes of defects ranged from 15 cm×6 cm to 30 cm×18 cm. Pedicled latissimus dorsi myocutaneous flaps were designed according to the defect area and raised with part of latissi-mus dorsi. The thoracodorsal artery and its perforators were carefully protected during surgery. Results: All flaps healed primarily without flap congestion, margin necrosis or infection. The skin donor sites either received split-thickness skin graft (3 cases, mostly from the anterior thigh) or was closed primarily (3 cases) and had minimal morbidity. Follow-up of 6-12 months showed that the contour of flap was aesthetic and the func-tion of limb was excellent. Conclusion: Our experience indicates that the pedicled latissimus dorsi myocutaneous flap is favorable for recon-struction of large skin and soft tissue defects in the upper extremity. Key words: Surgical flaps; Upper extremity; Soft tissue injuries; Reconstructive surgical procedures