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Updated: Jun 10, 2025
Porcine As a Training Module for Head and Neck Microvascular Reconstruction
Published on: September 29, 2018
Salvage Operation of Head and Neck Reconstruction Using a Pedicled Latissimus Dorsi Myocutaneous Flap with Distally
Tsubasa Kojima1, Hisashi Motomura1, Ayaka Nochi Deguchi1
1From the Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan.
Background:
There are many situations in head and neck reconstruction where a pedicled flap must be chosen over free flaps. In such situations, one of our options is a pedicled latissimus dorsi (LD) myocutaneous flap with distally positioned skin paddle with a more distal skin flap design.
Methods:
We performed 22 reconstruction cases using a distally positioned pedicled LD myocutaneous flap. When designing the skin paddle more distally than usual, it is important to include the lateral cutaneous branch of the 10th posterior intercostal artery. By splitting the skin paddle sections, the LD flap is flexible for use in complex head and neck defects. It can also be used for mandibular reconstruction by harvesting the flap with costal bone.
Results:
In all cases, the skin flaps survived, with a salvage rate of 100%.
Conclusions:
Because elevation of this flap is relatively easy, safe, and quick, this flap selection is considered practical in salvage cases after flap necrosis, and in cases after multiple procedures.
