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Reverse-supercharged, distally based latissimus dorsi flap for lumbar defect: A case report
Ryusho Hamada1,2, Akira Shinaoka2,3, Toshiyuki Watanabe2
1Department of Plastic Surgery, National Hospital Organization Iwakuni Clinical Center, Yamaguchi, Japan.
Microsurgery
|May 8, 2019
Summary
This study presents a novel reverse-supercharge technique to salvage a distally based latissimus dorsi flap for lumbar soft tissue defects. The successful flap reconstruction ensured good vascularity and patient recovery.
Area of Science:
- Plastic Surgery
- Microsurgery
- Reconstructive Surgery
Background:
- Successful soft tissue defect reconstruction in the lumbar region requires well-vascularized tissue.
- Optimal reconstructive techniques for lumbar defects remain a subject of debate.
- Large lumbar defects pose significant reconstructive challenges.
Observation:
- A distally based latissimus dorsi flap was initially used for a 15x12 cm lumbar defect.
- Vascular insufficiency of the flap was noted after tunneling.
- A reverse-supercharge technique was employed using a serratus anterior branch.
Findings:
- Microvascular anastomosis of the serratus anterior branch to a lumbar perforator improved flap vascular supply.
- The flap survived uneventfully without venous congestion.
- The patient experienced a successful recovery and had no tumor recurrence at 2-year follow-up.
Implications:
- The reverse-supercharge technique can salvage distally based latissimus dorsi flaps with vascular compromise.
- This method provides a valuable alternative for lumbar region reconstruction when other options are limited.
- Successful flap survival demonstrates the efficacy of supercharging in challenging reconstructive scenarios.
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