Cinical Application of the Free Flap Based on the Musculocutantaneous Perforators of the Thoracodorsal Vessels

ABSTRACT

The latissimus dorsi muscle or musculocutaneous flap is one of the most useful flaps in reconstructive surgery. This flap has many advantages, such as its reliable anatomy, long pedicle with large caliber vessels, minimal functional deficit of the donor site, and low incidence of donor site complications. However, the bulkiness of the flap has been considered a disadvantage, so various modifications of technique have been devised. The cutaneous portion of the flap can be safely elevated based on the cutaneous perforating branch of the thoracodorsal vessel. From March 1997 to February 1998, 10 patients underwent reconstructive procedures with thoracodorsal perforator-based free flaps. The composition of the flaps varied in accordance with the nature of the defect. The variances in the flaps were as follows; 3 were cutaneous, 6 musculocutaneous, and 1 osteomusculocutaneous including the rib. All flaps survived with good contour. We concluded that this thin and reliable flap was useful for reconstruction of various defects, and that the composition of the flap, such as subcutaneous, muscle and bone, gave it considerable flexibility as needed.