Advance Search

Latissimus dorsi muscle free flap for management of large complex wound

Abdlrahman Baiz Abdlrahman Miran
Department of Plastic Surgery, Ministry of Health, Erbil, Iraq.
Keywords:
Copyright and Licensing:

Copyright (c) 2023 Abdlrahman Baiz Abdlrahman Miran (Author)

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

Share:
Crossref
Scopus
Google Scholar
Europe PMC

Abstract

Background and objective: Dealing with a large complex wound is very challenging, and latissimus dorsi flap through history has been used as its very variable and flexible in the form of pedicle or free flap in the coverage of those large complex wounds as its large, well perfused, and flexible in configuration. The study aimed to evaluate the versatility of use and viability of latissimus dorsi free flap for coverage of large complex wounds in different parts of the body.

Methods: A retrospective study was conducted from 2012 to 2019 in Erbil Rizgary teaching hospital, Rozhawa emergency hospital, and PAR private hospital, Kurdistan region, Iraq on 22 cases, (20) male (90.9%), and (2) female (9.1%), all with a large complex wound in different sites of the body that latissimus dorsi free flap in the form of myocutaneous mainly and only one with muscle free flap.

Results: The complex large wounds ranged from (22*15 cm – 35*20 cm) indifferent sites of the body, (18) from the lower limb,(3) from the forearm and (1) from the scalp, from those 22 cases, we had 17 cases that survived totally(77.2%), and 5 failure cases (22.7%) those were from leg who associated with tibial bone fracture gestilo type 111B and C and large soft tissue defect with or without vascular injury, and in regard to flaps out of 22 cases 5 of them presented with total necrosis (55.6%), one case with partial necrosis(11.1%), and 3 cases with partial skin graft loss (33.33%), that managed conservatively, in all cases donor site closed primarily with few morbidities as happened in 5 cases (22.7%) like bleeding in 3 cases (60.0%) and stoppage needed operation theater, one case (20.0%) with seroma, and one with minor wound dehiscent (20.0%), that both managed conservatively.

Conclusion: The latissimus dorsi myocutaneous free flap is the reliable, flexible and highly recommended for large soft tissue defect reconstruction in different sites of the body especially those associated with extensive bone damage.

PDF
PDF

Metrics

Metrics Loading ...

References

  1. Manrique OJ, Bustos SS, Pafitanis G, Forte AJ, Huayllani MT, Boczar D, et al. The modified extended fleur-de-lis latissimus dorsi flap for various complex multi-directional large soft and bone tissue reconstruction. Cureus. 2020; 12(2): DOI: 10.7759/cureus.6974
  2. Kim JT, Kim YH, Ghanem AM. Perforator chimerism for the reconstruction of complex defects: a new chimeric free flap classification system. JPRAS. 2015; 68(11):1556–67. DOI: 10.1016/j.bjps.2015.07.004
  3. Sood A, Therattil PJ, Russo G, Lee ES. Functional latissimus dorsi transfer for upper-extremity reconstruction: a case report and review of the literature. Eplasty. 2017; 17. PMCID: PMC5317028
  4. Abo-Hashem A, Zakaria Y. Role of Latissimus Dorsi Island Flap in Coverage of Mutilating Upper Limb Injuries in Pediatric Age Group. AOPS. 2010; 6(3-4):154–60. eISSN: 1687-4137
  5. Ayad WM, Mohammed AH, Ismail HM, Ouf MO, Elbatawy AM. Free Latismus Dorsi Muscle Flap with a Flow-Through Technique for Lower Limb Salvage. Arch Hand Microsurg. 2019; 24(2):177–82. DOI: https://doi.org/10.12790/ahm.2019.24.2.177
  6. Kang MJ, Chung CH, Chang YJ, Kim KH. Reconstruction of the lower extremity using free flaps Arch Plast Surg. 2013; 40(5):575. DOI: 10.5999/aps.2013.40.5.575
  7. Sofiadellis F, Liu DS, Webb A, MacGill K, Rozen WM, Ashton MW. Fasciocutaneous free flaps are more reliable than muscle free flaps in lower limb trauma reconstruction: experience in a single trauma center. J Reconstr Microsurg. 2012; 28(05):333–40. DOI: 10.1055/s-0032-1313764
  8. Richards RR, McKee MD, Paitich CB, Anderson GI, Bertoia JT. A comparison of the effects of skin coverage and muscle flap coverage on the early strength of union at the site of osteotomy after devascularization of a segment of canine tibia. J Bone Joint Surg Am. 1991; 73(9):1323–30. PMID: 1918114
  9. Harry LE, Sandison A, Paleolog EM, Hansen U, Pearse MF, Nanchahal J. Comparison of the healing of open tibial fractures covered with either muscle or fasciocutaneous tissue in a murine model. J Orthop Res. 2008; 26(9):1238–44. DOI: 10.1002/jor.20649
  10. Jeon BJ, Lee TS, Lim SY, Pyon JK, Mun GH, Oh KS, et al. Risk factors for donor-site seroma formation after immediate breast reconstruction with the extended latissimus dorsi flap: a statistical analysis of 120 consecutive cases. Ann Plast Surg. 2012; 69(2):145–7. DOI: 10.1097/sap.0b013e3182259337
  11. Shin IS, Lee DW, Lew DH. Efficacy of quilting sutures and fibrin sealant together for prevention of seroma in extended latissimus dorsi flap donor sites. Arch Plast Surg. 2012; 39(5):509. DOI: 10.5999/aps.2012.39.5.509
How to Cite
Baiz Abdlrahman Miran, A. (2023). Latissimus dorsi muscle free flap for management of large complex wound. Zanco Journal of Medical Sciences (Zanco J Med Sci), 27(2), 124–135. https://doi.org/10.15218/zjms.2023.015

Send mail to Author

Send Cancel