scholarly journals Versatility of Latissimus Dorsi Free Flap-a Prospective Study

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

Free latissimus dorsi flap with long venous grafts for closure of a soft tissue defect of the spine in a patient with Noonan's syndrome: A case report

Microsurgery ◽  
2009 ◽  
Vol 29 (6) ◽  
pp. 486-489 ◽  
Author(s):  
Nektarios Sinis ◽  
Tatjana Ismini Lanaras ◽  
Armin Kraus ◽  
Frank Werdin ◽  
Hans-Eberhard Schaller ◽  
...  
Keyword(s):  
Case Report ◽  
Soft Tissue ◽  
Latissimus Dorsi ◽  
Soft Tissue Defect ◽  
Latissimus Dorsi Flap ◽  
Tissue Defect ◽  
Venous Grafts ◽  
Noonan's Syndrome ◽  
Free Latissimus Dorsi Flap ◽  
Noonan’S Syndrome

Simultaneous Reconstruction of the Achilles Tendon and Soft-Tissue Defect Using Only a Latissimus Dorsi Muscle Free Flap

1999 ◽  
Vol 104 (1) ◽  
pp. 111-119 ◽  
Author(s):  
Hoon-Bum Lee ◽  
Dae-Hyun Lew ◽  
Seung-Hoon Oh ◽  
Kwan-Chul Tark ◽  
Sug-Won Kim ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Achilles Tendon ◽  
Free Flap ◽  
Latissimus Dorsi ◽  
Soft Tissue Defect ◽  
Latissimus Dorsi Muscle ◽  
Tissue Defect ◽  
Dorsi Muscle ◽  
Simultaneous Reconstruction

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

2021 ◽  
Author(s):  
Abulaiti Abula ◽  
Yanshi Liu ◽  
Feiyu Cai ◽  
Kai Liu ◽  
Peng Ren ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Clinical Application ◽  
Latissimus Dorsi ◽  
Myocutaneous Flap ◽  
Donor Site ◽  
Soft Tissue Defect ◽  
High Survival ◽  
Skin Flaps ◽  
Tissue Defect ◽  
Latissimus Dorsi Myocutaneous Flap

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.

scholarly journals Customized Reconstruction of Complex Soft Tissue Defect Around the Knee with Individual Design of Free Perforator Flap

2020 ◽  
Author(s):  
Jinfei Fu ◽  
Liming Qing ◽  
Panfeng Wu ◽  
Zhengbing Zhou ◽  
Fang Yu ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Donor Site ◽  
Perforator Flap ◽  
Donor Site Morbidity ◽  
Soft Tissue Defect ◽  
Soft Tissue Reconstruction ◽  
Knee Region ◽  
Tissue Defect ◽  
Individual Design ◽  
Free Perforator Flap

Abstract Background Reconstruction of complex soft tissue defect around the knee, particularly in involving with large soft tissue defect or disruption of extensor mechanism, always is a challenging problem. The purpose of this study was to introduce our clinical experience on using individual design of free perforator flap for complex soft-tissue reconstruction around the knee. Methods Between June 2010 and March 2017, 16 patients underwent the reconstruction of complex soft tissue defect in the knee region with free perforator flap, Various flap designs was performed basing on the location of wound, the require pedicle length, the tissue components that are deficient, the volume of such components and the risk of donor site morbidity.Results Complex soft tissue defect of the knee was reconstructed with anteriorlateral thigh perforator (ALTP) flap in 5 cases, modified ALTP flap in 2 cases, chimeric ALTP flap in 4 cases, dual skin paddles ALTP flap in 2 cases and chimeric thoracodorsal artery perforator (TDAP) flap in 2 cases. Multiple perforator flaps and vascularized fascia lata in combination were performed in one case. All flaps survived postoperative. None vascular congestion was observed. Only one case suffered partial necrosis. Primary closure of donor site was performed for all patients. The mean follow-up time was 16.5 months. Most cases showed satisfactory flap contour and acceptable function outcome. Conclusions Free perforator flap is a reliable option for repairing complex soft tissue defect in the knee region, especially when local and pedicled flaps are unavailable. Various flap designs allow for more individualized treatment approaches.

Heterodigital Free Flap of Index Finger Amputee for Coverage of the Long Finger Soft Tissue Defect

2013 ◽  
Vol 22 (2) ◽  
pp. 82-85 ◽  
Author(s):  
So-Min Hwang ◽  
Jang Hyuk Kim ◽  
Hong-Il Kim ◽  
Yong-Hui Jung ◽  
Hyung-Do Kim
Keyword(s):  
Soft Tissue ◽  
Free Flap ◽  
Index Finger ◽  
Soft Tissue Defect ◽  
Tissue Defect

scholarly journals Laparoscopically Harvested Omental Free Flap to Cover a Large Soft Tissue Defect

1993 ◽  
Vol 217 (5) ◽  
pp. 542-547 ◽  
Author(s):  
Renato Saltz ◽  
Robert Stowers ◽  
Michael Smith ◽  
Thomas R. Gadacz
Keyword(s):  
Soft Tissue ◽  
Free Flap ◽  
Soft Tissue Defect ◽  
Tissue Defect

LONG-TERM DONOR-SITE MORBIDITY IN COMPOSITE ANTEROLATERAL THIGH FREE FLAP FOR COMPLEX DEFECT OF LOWER LEG AND FOOT RECONSTRUCTION

2020 ◽  
pp. 85-91
Author(s):  
Phuc Le Hong ◽  
Son Tran Thiet ◽  
Thuy Nguyen Xuan
Keyword(s):  
Soft Tissue ◽  
Skin Graft ◽  
Free Flap ◽  
Donor Site ◽  
Lower Extremities ◽  
Lower Leg ◽  
Donor Site Morbidity ◽  
Thigh Circumference ◽  
Anterolateral Thigh

Background: In recent years, the composite anterolateral thigh free flap with tensor fasciae latae or vastus lateralis has been a new-applied type of flap that can provide very good reconstruction materials in complex defects of lower leg and foot. The study purpose is to evaluate the systematically complications of donor site, related factors to results of the donor area, in order to apply the result to improve the treatment, which have not been much reported in literature. Materials and Methods: Systematic donor site morbilidy evaluation in a prospective, uncontrolled clinical descriptive study of 33 composite anterolateral thigh free flaps in various forms to reconstruct anatomical structures or to resconstruct deep defects combined with covering the surfaces for complex soft tissue defects in lower extremities for 32 patients due to different causes in lower leg and foot area from 2014-2019 at Hue University of Medicine and Pharmacy. Examining and evaluating aesthetic and functional result of donor-site 3 months and 6 months up to 2 year after surgery; evaluating the correlation between the width and the type of the flaps and donor site closure methods. Result: In 33 composite flaps used, flap width to thigh circumference less than 20% in 27 cases (81.8%), more than 20% in 6 cases (18.20% ); There were 28 cases in which the donor site was directly closed, 5 cases required skin graft; All direct closed cases had flap width/ thigh circumference index below 20%; On the contrary, in cases having this index greater than 20%, the donor site required skin graft with p < 0.01. There are 11/33 (33.33%) of cases reported complications in donor site ; lateral thigh paresthesia is the most complicated complication with 8/33 cases (24.24%), followed by bad scarring 3/33 cases (9.09%). Conclusion: Long term follow up donor site morbility after composite anterior thigh free flap present 11/33 cases (33.33%): mostly complications of the donor site are thigh paresthesia with 8/33 cases (24.24%), and bad scarring 3/33 cases (9,09%), which improve time by time. Keywords: Composite anterior thigh free flap, lower extremities soft tissue defect, donor site morbidity

scholarly journals Results of Microvascular Free Flap for Reconstruction of Soft Tissue Defects: Our Early Experience

2014 ◽  
Vol 3 (2) ◽  
pp. 33-37
Author(s):  
Debashis Biswas ◽  
Md Abul Kalam ◽  
Tanveer Ahmed ◽  
Md Rabiul Karim Khan
Keyword(s):  
Soft Tissue ◽  
Free Flap ◽  
Free Flaps ◽  
Soft Tissue Defect ◽  
Soft Tissue Defects ◽  
Tissue Defect ◽  
Radial Forearm ◽  
After Cancer ◽  
Microvascular Free Flap ◽  
Tissue Defects

Extensive soft tissue defects following trauma, burn or after cancer surgery need coverage by flaps. Sometimes surrounding tissues are not healthy enough or quantity is not favorable to provide adequate pedicle flaps. Microvascular free flap can provide healthy tissue of adequate amount from distant area for those difficult situations.15 microvascular free flaps were performed from October 2011 to February 2013. Radial forearm free flap was done in 8 and Latissimusdorsi (LD) flap in 7 cases. 10 flaps done in foot, ankle & lower leg region (radial forearm-5, LD-5) and 5 flaps were done in face and scalp region (radial forearm-4, LD-1).12 flaps healed uneventfully with good coverage of the defect. Average ischemia time was 135 min (range 100-240 min) and average anastomosis time was 75 min (average 60-100 min). 2 flaps failed. There was necrosis of the tip of 2 LD and cumbersome swelling of the flap was found in 2 cases of LD flaps.Large soft tissue defect of body where local or regional flaps are not feasible; can be easily covered with free flaps. Its capacity to cover huge soft tissue defect has neutralizes its technical demand. Though complications are still high in our hands; can be reduced performing more number of cases. DOI: http://dx.doi.org/10.3329/bdjps.v3i2.18242 Bangladesh Journal of Plastic Surgery July 2012, 3(2): 33-37

scholarly journals The Pedicled Latissimus Dorsi Flap Provides Effective Coverage for Large and Complex Soft Tissue Injuries Around the Elbow

Hand ◽  
2017 ◽  
Vol 13 (5) ◽  
pp. 586-592 ◽  
Author(s):  
Jacques H. Hacquebord ◽  
Douglas P. Hanel ◽  
Jeffrey B. Friedrich
Keyword(s):  
Soft Tissue ◽  
Latissimus Dorsi ◽  
Soft Tissue Injuries ◽  
Soft Tissue Defect ◽  
Latissimus Dorsi Flap ◽  
Soft Tissue Coverage ◽  
Effective Coverage ◽  
Latissimus Flap ◽  
Proximal Forearm

Background: The pedicled latissimus flap has been shown to provide effective coverage of wounds around the elbow with an average size of 100 to 147 cm2 but with complication rates of 20% to 57%. We believe the pedicled latissimus dorsi flap is an effective and safe technique that provides reliable and durable coverage of considerably larger soft tissue defects around the elbow and proximal forearm. Methods: A retrospective review was performed including all patients from Harborview Medical Center between 1998 and 2012 who underwent coverage with pedicled latissimus dorsi flap for defects around the elbow. Demographic information, injury mechanism, soft tissue defect size, complications (minor vs major), and time to surgery were collected. The size of the soft tissue defect, complications, and successful soft tissue coverage were the primary outcome measures. Results: A total of 18 patients were identified with variable mechanisms of injury. Average defect size around the elbow was 422 cm2. Three patients had partial necrosis of the distal most aspect of the flap, which was treated conservatively. One patient required a secondary fasciocutaneous flap, and another required conversion to a free latissimus flap secondary to venous congestion. Two were lost to follow-up after discharge from the hospital. In all, 88% (14 of 16) of the patients had documented (>3-month follow-up) successful soft tissue coverage with single-stage pedicled latissimus dorsi flap. Conclusions: The pedicled latissimus dorsi flap is a reliable option for large and complex soft tissue injuries around the elbow significantly larger than previous reports. However, coverage of the proximal forearm remains challenging.

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