Latissimus dorsi musculocutaneous flap based on the serratus branch with microvascular venous augmentation

The authors report a case of a latissimus dorsi musculocutaneous flap with microvascular venous supercharging in the setting of an acute ligation of the thoracodorsal vascular pedicle. Through their experience with this case, they have questioned a common belief that the flap will survive without the thoracodorsal vessels intact. They accept that risk is minimized when rotation of the flap takes place several weeks after ligation of the vessels. However, they do not believe it is prudent to transfer a latissimus flap of significant size immediately after ligation of the thoracodorsal vessels, unless the vascular supply is enhanced.