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

Area of Science:

• Plastic Surgery
• Reconstructive Surgery
• Orthopedic Surgery

Background:

• Pedicled latissimus flap is used for elbow wound coverage.
• Previous studies report average wound sizes of 100-147 cm².
• Reported complication rates range from 20% to 57%.

Purpose of the Study:

• Evaluate the pedicled latissimus dorsi flap for large soft tissue defects around the elbow.
• Assess the safety and efficacy of this technique for larger defects.
• Determine complication rates and success of soft tissue coverage.

Main Methods:

• Retrospective review of patients from Harborview Medical Center (1998-2012).
• Inclusion criteria: coverage with pedicled latissimus dorsi flap for elbow defects.
• Data collected: demographics, injury, defect size, complications, time to surgery.

Main Results:

• 18 patients reviewed with diverse injury mechanisms.
• Average defect size was 422 cm².
• 88% (14/16) achieved successful single-stage coverage; complications included partial flap necrosis and venous congestion requiring secondary procedures.

Conclusions:

• Pedicled latissimus dorsi flap is reliable for large, complex elbow soft tissue injuries.
• The technique is effective for defects significantly larger than previously reported.
• Coverage of proximal forearm defects remains a challenge.