Pedicled Latissimus Dorsi Myocutaneous Flap Transthoracic Transposition for Repairing Neck and Shoulder Soft Tissue Defect Combined with Infection

Abstract Background: To explore the clinical application and selection of latissimus dorsi myocutaneous flap in repairing neck and shoulder soft tissue defect combined with infection. Methods: From July 2017 to December 2019, 11 patients with neck and shoulder soft tissue defect combined with infection in our hospital were repaired by the pedicled latissimus dorsi myocutaneous flap (PLDMF) according to the shape and size of the soft tissue defects, including 9 males and 2 females, with an average age of 40.2±12.6 years. The average defect area after debridement of infected and necrotic tissue was (7.0±1.3) cm × (4.8±1.2) cm, and the average area of the flaps was (34.4±3.8) cm × (6.0±1.0) cm. The donor site was sutured directly. Results: Seven cases of skin flaps healed by the first intention, while 4 cases developed infections at the distal ends of the skin flaps after surgery, which all survived after anti-infection treatment and repeated dressing changes for infection control, and the donor and recipient sites of the flaps healed well. Followed up for an average of 17.3±3.8 months with good flap blood supply and limb function, there was no recurrence of infection. Conclusions: PLDMF is an idea for repairing neck and shoulder soft tissue defect combined with infection, with high survival rate, low postoperative infection recurrence rate, and good functional repair ability, leading to good clinical application value. However, surgical indications should be strictly carried out due to the inferior aesthetic of flaps.

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Soft Tissue Defects of Neck and Shoulder Managed by Pedicled Latissimus Dorsi Myocutaneous Flap Transthoracic Transposition

10.21203/rs.3.rs-998224/v1 ◽

2021 ◽

Author(s):

Abulaiti Abula ◽

Yanshi Liu ◽

Feiyu Cai ◽

Kai Liu ◽

Peng Ren ◽

...

Keyword(s):

Soft Tissue ◽

Blood Supply ◽

Latissimus Dorsi ◽

Myocutaneous Flap ◽

Donor Site ◽

High Survival ◽

Soft Tissue Defects ◽

Aesthetic Appearance ◽

Latissimus Dorsi Myocutaneous Flap ◽

Tissue Defects

Abstract BackgroundThe purpose of this study was to evaluate the effectiveness of latissimus dorsi myocutaneous flap in repairing neck and shoulder soft tissue defects combined with infection.MethodsA total of 11 patients with neck and shoulder soft tissue defects combined with infection, from July 2017 to December 2019, were treated by pedicled latissimus dorsi myocutaneous flap (PLDMF) in our department. There were 9 males and 2 females with an average age of 40.2±12.6 years. The mean defect size after debridement was (7.0±1.3) cm × (4.8±1.2) cm, and the average size of the flaps was (34.4±3.8) cm × (6.0±1.0) cm. The donor site was sutured directly. The postoperative blood supply in the transferred flap and function recovery of the affected limb were retrospectively collected and analyzed.ResultsSeven cases obtained direct healed without significant complications. Four cases developed postoperative infections at the distal ends of the skin flaps, and they were successfully treated by anti-infection treatment and repeated dressing changes. All patients were regularly followed up with an average of 17.3±3.8 months, satisfactory results with good flap blood supply and limb function were achieved in all patients, and no recurrence of infection was observed. ConclusionsPLDMF is a practically alternative treatment for the reconstruction of soft tissue defects combined with infection in neck and shoulder, including advantages of high survival rate, satisfactory functional recovery, and clinical practicality. However, surgical indications should be taken into account due to the inferior aesthetic appearance, especially for young female.

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Versatility of Latissimus Dorsi Free Flap-a Prospective Study

Journal of Dhaka Medical College ◽

10.3329/jdmc.v28i2.51149 ◽

2021 ◽

Vol 28 (2) ◽

pp. 142-152

Author(s):

Abu Faisal Md Ariful Islam ◽

Mohammad Rabiul Karim Khan ◽

Sharmin Akter Sumi ◽

Mohammad Hedayet Ali Khan ◽

Md Abul Kalam

Keyword(s):

Soft Tissue ◽

Free Flap ◽

Latissimus Dorsi ◽

Donor Site ◽

Donor Site Morbidity ◽

Soft Tissue Defect ◽

Latissimus Dorsi Flap ◽

Tissue Defect ◽

Medical College ◽

The Mean

Introduction: Free flaps offer a great variable of available tissues to cover larger, multifocal or multistructural defects. The choice among different free flap is dependent upon their recipient site requirement. Reconstruction with latissimus dorsi flap is now versatile tool in coverage. It can resurface large wound with reliable vascularity, consistent anatomy ,long pedicle length, opportunity for tailoring of flap. It has less donor site morbidity and has very little post-operative complications. Objective: To evaluate the versatility of free Latissimus dorsi flap for soft tissue reconstruction. Materials and methods: A prospective, observational study design was used in Department of Plastic Surgery of Dhaka Medical College and Hospital. Here 20 patients with soft tissue defect of variable sizes over lower limb, head neck and trunk underwent coverage with microvascular surgery. The study was carried out from July 2017 to June 2018. Result: Regarding the age distribution, the mean age was 35.65with an SD of + 10.81. The lowest age was 20years and the highest age was 56 years, Male female ratio was 3:2.The major cause (65.0%) of soft tissue defect of the samples was RTA. The flap was used to reconstruct the soft tissue defect over lower leg in 13 (65%)cases, on scalp 05 (25%) cases and over anterior trunk in two cases. The mean flap dimension was 229.25cm2 and its range was between 120 – 384 cm2. The standard myocutaneous flap was harvested in 80% cases, chimeric (10%) and partial Latissimus muscle flap in two cases. The donor site in all the 20 (100%) cases was closed primarily. The outcome of reconstruction was excellent in 16(80%), good in 02 (10%) cases and poor in 02 (10%) cases. There was no significant complication during the three months postoperative period. Conclusion: The Latissimus dorsi flap is a versatile option for resurfacing the soft tissue defect in different areas of the body with variable flap components and with minimal donor site morbidity. J Dhaka Medical College, Vol. 28, No.2, October, 2019, Page 142-152

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