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Related Experiment Video

Updated: Jul 15, 2026

The Transition to an Anterior-Based Muscle Sparing Approach Improves Early Postoperative Function but is Associated with a Learning Curve
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Latissimus dorsi free flaps for complex ischiosacral defects.

Beejay Feliciano1, Keith T Paige, Kevin M Beshlian

  • 1Section of Plastic and Reconstructive Surgery, Virginia Mason Medical Center, Mailstop: X11-PRS, 1100 Ninth Ave., P.O. Box 900, Seattle, WA 98111, USA.

American Journal of Surgery
|April 17, 2007
PubMed
Summary

Free latissimus flaps effectively cover ischiosacral defects using gluteal or femoral vessels. This surgical approach offers a viable solution for complex wound coverage in this challenging anatomical region.

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Area of Science:

  • Plastic Surgery
  • Reconstructive Surgery

Background:

  • Free tissue transfer for ischiosacral defects is often limited by recipient vessel availability.
  • Complex wounds in the ischial and sacral areas pose reconstructive challenges.

Observation:

  • A retrospective review of 3 patients with ischiosacral defects treated with free tissue transfer.
  • Patient conditions included quadriplegia and ambulatory status.

Findings:

  • Successful coverage of ischiosacral defects was achieved in all 3 patients using free latissimus flaps.
  • Recipient vessels included both local gluteal vessels (2 patients) and a regional arteriovenous loop to femoral vessels (1 patient).
  • All flaps survived, and wounds healed completely.

Implications:

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  • Free latissimus flaps are an effective option for ischiosacral defect reconstruction.
  • Both local gluteal and regional femoral vessels can be successfully utilized as recipient vessels for these flaps.
  • This technique expands reconstructive possibilities for complex perineal and sacral wounds.