Primary donor-site closure of a large latissimus dorsi myocutaneous flap using the perforator propeller flap technique
10.3760/cma.j.cn114453-20191003-00292
- VernacularTitle:穿支螺旋桨皮瓣修复背阔肌肌皮瓣供区缺损
- Author:
Tinglu HAN
1
;
Mengqing ZANG
;
Shan ZHU
;
Bo CHEN
;
Shanshan LI
;
Tingjun XIE
;
Bin HUA
;
Yuanbo LIU
Author Information
1. 中国医学科学院北京协和医学院整形外科医院瘢痕综合治疗中心 100144
- Keywords:
Latissimus dorsi myocutaneous flap;
Reconstructive surgical procedures;
Perforator propeller flap
- From:
Chinese Journal of Plastic Surgery
2020;36(9):970-975
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the feasibility and technical tips of donor-site reconstruction of the latissimus dorsi myocutaneous flap using the perforator propeller flap technique.Methods:Between July 2012 and January 2019, a total of 24 patients, including 9 males and 15 females, underwent reconstructions of defects in various locations using the latissimus dorsi myocutaneous flap. The average patient age was 43.6 years (range, 4-81 years). Before surgery, perforators adjacent to the latissimus dorsi muscle were explored using an ultrasound Doppler probe and marked on the skin. A latissimus dorsi myocutaneous flap was elevated according to the resultant defect following the removal of the lesion and transferred to reconstruct the defect. The donor-site defects were reconstructed using one, dual, or even triple perforator propeller flap.Results:All the 24 myocutaneous flaps survived completely. The dimension and width of the myocutaneous flaps ranged from 16 cm × 11 cm to 33 cm × 17 cm and 9 cm to 20 cm, respectively. The donor-site defects of the myocutaneous flap were all closed by perforator propeller flaps including 22 pedicled flaps and 2 free flaps. The defect was reconstructed by one perforator propeller flap in 12 patients, two flaps in 11, and three flaps in the remaining one patient. There were 36 posterior intercostal artery perforator propeller flaps and one freestyle perforator propeller flap. The size, pedicle length, and rotation angle of the propeller flaps were 13 cm × 5 cm to 23 cm × 14 cm, 3 cm to 6 cm, and 90 to 180 degrees, respectively. All the donor sites of the perforator propeller flaps were closed primarily. Total necrosis of the propeller flap occurred in one patient and small-sized distal flap necrosis in another one. The remaining propeller flaps survived completely. All patients were followed up for one to 38 months and the mean follow-up time was 7 months. Tumor recurrence was noticed in four patients. All patients were satisfied with the final functional and aesthetic outcomes.Conclusions:Using the perforator propeller flaps could guarantee not only harvesting a wide latissimus dorsi myocutaneous flap, but also primary donor-site closure of the myocutaneous flap, and therefore greatly improve the versatility and capability of the latissimus dorsi myocutaneous in defect reconstruction.
