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An extended latissimus dorsi "non-free" flap
1Division of Plastic Surgery, Allentown Affiliated Hospitals, Pennsylvania.
British Journal of Plastic Surgery
|September 1, 1987
Summary
This study details a novel technique for latissimus dorsi flap transfer, maintaining perfusion via a secondary blood supply during pedicle lengthening. This innovative method ensures flap viability without requiring immediate microvascular anastomosis.
Area of Science:
- Plastic Surgery
- Microsurgery
- Reconstructive Surgery
Background:
- Sacral defects pose reconstructive challenges.
- Latissimus dorsi flaps are commonly used for reconstruction.
- Pedicle lengthening can be necessary for flap placement.
Observation:
- A latissimus dorsi musculocutaneous flap was transferred to a sacral defect.
- The flap's primary blood supply (thoracodorsal pedicle) was lengthened using saphenous vein grafts.
- Perfusion was maintained through the flap's secondary blood supply during this process.
Findings:
- The flap remained viable throughout the procedure, supported by its secondary blood supply.
- The secondary blood supply was only divided after successful microvascular anastomoses were established.
- This approach avoided the flap being a completely "free" flap at any stage.
Implications:
- This technique offers a potential solution for maintaining flap perfusion during complex reconstructive procedures.
- It may reduce the risk of flap failure in challenging reconstructions.
- This method could be valuable in cases requiring extended pedicle length.