Latissimus dorsi flap as a rescue flap

The latissimus dorsi flap was the first described in medical literature. The first use is attributed to Tansini in 1896, when applied it to breast reconstruction after radical mastectomy. In 1978 Quillen used the pedicle form for face and neck defects reconstruction. One year later, Watson created the first application of it as a free vascularized flap. This flap, in both forms, was really popular in the 80s because it is easy to dissect, the neurovascular pedicle is long and wide, it has a large area and low donor site morbidity. We present 2 cases of secondary reconstruction with latissimus dorsi muscle flap:

First case: 40 year old woman who presented a right craniofacial giant basal cell carcinoma. It was observed facial nerve paralysis. We performed resection and reconstruction with rectus abdominis microsurgical flap. After checking that this flap was not viable, we took it out and then we secondary reconstructed the defect with microsurgical latissimus dorsi flap.

Second case: 63 year old man who presented a left retromolar trigone and a synchronous larynx squamous cell carcinoma. We performed tumor resection with segmental mandibulectomy, an horizontal supraglottic laryngectomy, a left functional cervical dissection, and reconstructed it with microsurgical fibula free flap. After dehiscence and necrosis of soft tissue flap, a new flap reconstruction using pedicle pectoralis major was done. Then, the patient presented a new cervical dehiscence because of a pharyngostoma. He had to be intervened again to cover dehiscence and repair the pharyngostoma with a pedicle latissimus dorsi flap.

Conflict of interest: None declared.

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Jan 27, 2018 | Posted by in Oral and Maxillofacial Surgery | Comments Off on Latissimus dorsi flap as a rescue flap
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