Use of pedicled latissimus dorsi myocutaneous flap to reconstruct the upper limb with large soft tissue defects

摘要

Objective:To report the technique of reconstruction of large skin and soft tissue defects in the upper extremity using pedicled latissimus dorsi myocutaneous flaps.Methods:Six patients with large skin and soft tissue defects were included in this report.There were 5 trauma patients and the rest one needed to receive plastic surgery for his extremity scar.All wounds were in the upper extremity.The sizes of defects ranged from 15 cm×6 cm to 30 cm× 18 cm.Pedicled latissimus dorsi myocutaneous flaps were designed according to the defect area and raised with part of latissimus dorsi.The thoracodorsal artery and its perforators were carefully protected during surgery.Results:All flaps healed primarily without flap congestion,margin necrosis or infection.The skin donor sites either received split-thickness skin graft (3 cases,mostly from the anterior thigh) or was closed primarily (3 cases)and had minimal morbidity.Follow-up of 6-12 months showed that the contour of flap was aesthetic and the function of limb was excellent.Conclusion:Our experience indicates that the pedicled latissimus dorsi myocutaneous flap is favorable for reconstruction of large skin and soft tissue defects in the upper extremity.