Anomalous arterial supply to the muscles in a combined latissimus dorsi and serratus anterior flap

2004 ◽  
Vol 17 (4) ◽  
pp. 358-359 ◽  
Author(s):  
A.S. Halim ◽  
Z. Wan
2019 ◽  
pp. 881-890
Author(s):  
Marek K. Dobke ◽  
Gina A. Mackert

Variants of the latissimus dorsi flap are quite versatile and offer multiple reconstructive options for creative surgeons. The latissimus dorsi flap may be raised as a muscle flap or together with the overlying skin as a musculocutaneous unit. Apart from its use as a pedicled flap or for microvascular free flap transfer, the latissimus dorsi can be raised with portions of ribs and may include the serratus anterior muscle. Different customized chimeric (muscle and perforator flap) or perforator flap techniques find application for repair difficult with large three-dimensional defects or when large and thin, skin-only tissue is needed, respectively. Different designs of the flap, dissection techniques, and flap variant applications in the context of a systematic approach to reconstructive problems are described.


2019 ◽  
Vol 12 (S 01) ◽  
pp. S50-S53
Author(s):  
Athanasios Karonidis ◽  
Akrivi Kostopoulou ◽  
Sofia Pappa ◽  
Dimosthenis Tsoutsos

AbstractThis article describes a rare case of giant cell tumor of the tendon sheath (GCTTS) that was developed over the substance of chimeric-free latissimus dorsi and ­serratus ­anterior muscle flaps performed for lower limb reconstruction. To our knowledge, development of GCTTS over a free flap is first described in the literature. A 71-year-old ­woman was presented with a large protuberant ulcerated tumor mass that was developed over the substance of chimeric free muscle flaps at the foot and ankle. We performed an extensive tumor resection, and the pathology report confirmed the presence of a primary giant cell tumor. The patient was advised to have a below-knee amputation. However, the patient refused the amputation, and 4 months later, she was presented with a metastatic mass proximally at the upper thigh. We believe that the GCTTS was associated with the chronic inflammation of the soft tissue and bones along with the recurrent episodes of infection, mainly due to proteus mirabilis and proteus syndrome (PS). PS may lead to the development of malformations and overgrowth of different tissues in unusual locations. In cases resistant to antibiotics, the radical surgical debridement should be considered as the most effective treatment.


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