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The unilateral reverse latissimus dorsi flap for soft tissue coverage of midline thoracal defects after spine surgery
Meirizal1, Rahadyan Magetsari1, Dea Prista Agatha1
1Department of Orthopaedics and Traumatology, Dr. Sardjito General Hospital/Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Sleman Regency, Yogyakarta Special Region, Indonesia.
Introduction:
The thoracolumbal region is often a difficult area to reconstruct for orthopaedic surgeons. Reconstruction of this area with a standard free tissue transfer is not always possible, and locoregional flaps are often failed due to poor quality outcome and mobilization difficulty.
Case Report:
A case was presented with unilateral distally based latissimus dorsi flaps reconstruction in patient with midline thoracal soft tissue defect underwent kyphosis deformity correction surgery. This study reported a patient, male, 33 years old who was diagnosed with ankylosing spondylitis and kyphosis deformity. The patient underwent surgical correction of the kyphosis deformity. After 1 month, the patient complained about his open surgical wounds.
Clinical Discussion:
In our institution, this patient underwent second debridement surgery and unilateral reverse latissimus dorsi flap for thoracal soft tissue defect coverage to obtain well-vascularised tissue, with good resistance to bacterial contamination and easy to shape into such defect. After follow-up for 6 months, the patient shows good outcome and postoperative wound healing was favorable.
Conclusion:
We believe that the "reverse" latissimus dorsi flap is a good option to cover this particular region. It is simple, safe, and reliable. It also provides a backup plan for the microsurgery in this region.
