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Dorsi Flap (dorsi + flap)

Distribution by Scientific Domains

Medical Sciences	100%

Kinds of Dorsi Flap

latissimu dorsi flap

Selected Abstracts

Autologous diaphragm reconstruction with the pedicled latissimus dorsi flap

JOURNAL OF SURGICAL ONCOLOGY, Issue 3 2006
M.O. McConkey BSc
Abstract The latissimus dorsi (LD) muscle has been previously described to repair diaphragmatic defects, but as a "reverse" flap, relying on secondary blood supply from the perforating lumbar vessels rather than primary inflow from the dominant thoracodorsal artery. We report resection of a retroperitoneal synovial sarcoma, with reconstruction of the hemidiaphragm using the LD rotated on its primary neurovascular bundle. By using the dominant pedicle, the vascularity of the flap is improved, minimizing the chance of flap tip loss. Maintaining an intact nerve supply prevents atrophy. As the distal origin of the LD is broad and flat, it is ideally suited for diaphragm repair. A latissimus-sparing thoracotomy incision is required to enable this method of diaphragm reconstruction. J. Surg. Oncol. 2006;94:248,251. © 2006 Wiley-Liss, Inc. [source]

The bipedicled latissimus dorsi myocutaneous free flap: Clinical experience with 53 patients

MICROSURGERY, Issue 3 2010
Mehmet Veli Karaaltin M.D.
The Latissimus dorsi musculocutaneous flap is a valuable workhorse of the microsurgeon, especially in closing large body defects. One of the pitfalls in harvesting the flap, is particularly in its inferior aspect which may be unreliable. Here we report a series of 53 patients who were undergone bipedicled free latissimus dorsi musculocutaneous free flaps for extensive tissue defects. The age of patients were between 5 and 64 and all of them were males. The wound sizes in these patients ranged between 31,35 × 10,12 cm and flap dimensions were between 38,48 × 6,8 cm. Perforator branches of the 10th intercostal vessels were dissected and supercharged to the flaps to reduce the risk of ischemia of the inferior cutaneous extensions. The secondary pedicles were anastomosed to recipient vessels other than the primary pedicles. Recipient areas were consisted of lower extremities. Four patients suffered of early arterial failure in the major pedicle and all revisions were successfully attempted. Neither sign of venous congestion nor arterial insufficiency were observed at the inferior cutaneous extensions of the flaps, and all defects were reconstructed successfully. All donor sites were primarily closed, only two patients suffered from a minor area of superficial epidermal loss at the donor site, without suffering any adjunct complications. In conclusion coverage of large defects can be safely performed with extending the skin paddle of latissimus dorsi flap as a bipedicled free flap. © 2009 Wiley-Liss, Inc. Microsurgery, 2010. [source]

Customized reconstruction with the free anterolateral thigh perforator flap

MICROSURGERY, Issue 7 2008
Holger Engel M.D.
From April of 2003 through September of 2006, 70 free anterolateral thigh (ALT) flaps were transferred for reconstructing soft-tissue defects. The overall success rate was 96%. Among 70 free ALT flaps, 11 were elevated as cutaneous ALT septocutaneous vessel flaps. Fifty-seven were harvested as cutaneous ALT myocutaneous "true" perforator flaps. Two flaps were used as fasciocutaneous perforator flaps based on independent skin vessels. Fifty-four ALT flaps were used for lower extremity reconstruction, 11 flaps were used for upper extremity reconstruction, 3 flaps were used for trunk reconstruction, and 1 flap was used for head and neck reconstruction. Total flap failure occurred in 3 patients (4.28% of the flaps), and partial failure occurred in 5 patients (7.14% of the flaps). The three flaps that failed completely were reconstructed with a free radial forearm flap, a latissimus dorsi flap and skin grafting, respectively. Among the five flaps that failed partially, three were reconstructed with skin grafting, one with a sural flap, and one with primary closure. The free ALT flap has become the workhorse for covering defects in most clinical situations in our center. It is a reliable flap with consistent anatomy and a long, constant pedicle diameter. Its versatility, in which thickness and volume can be adjusted, leads to a perfect match for customized reconstruction of complex defects. © 2008 Wiley-Liss, Inc. Microsurgery, 2008. [source]

Extremity salvage with a free musculocutaneous latissimus dorsi flap and free tendon transfer after resection of a large congenital fibro sarcoma in a 15-week-old infant.

MICROSURGERY, Issue 6 2006
A case report
A case of complex microsurgical reconstruction of the dorsum of the foot, including tendon transfer following tumor resection, in a 15-week-old male infant is presented. After birth, a 5.5 × 4 cm large tumor was observed on the dorsum of the right foot. Biopsy showed a congenital malignant fibro sarcoma. After initial chemotherapy a radical excision of the tumor at the age of 14 weeks was followed. To cover the defect a musculocutaneous latissimus dorsi flap was taken, the cutaneous part being large enough to cover the defect. Extensor tendons were reconstructed with free tendon transplants. Amputation is usually indicated in these cases. To the best of our knowledge, microsurgical reconstruction in infants at this age with congenital malignant tumors has not yet been reported. The case shows that Plastic surgery can play an important role in pediatric oncology and should routinely be integrated into the multi-modal treatment concepts. © 2006 Wiley-Liss, Inc. Microsurgery, 2006. [source]

Hemispheric brain volume replacement with free latissimus dorsi flap as first step in skull reconstruction

MICROSURGERY, Issue 4 2005
Anton H. Schwabegger M.D.
Large skull defects lead to progressive depression deformities, with resulting neurological deficits. Thus, cranioplasty with various materials is considered the first choice in therapy to restore cerebral function. A 31-year-old female presented with a massive left-sided hemispheric substance defect involving bone and brain tissue. Computed tomography showed a substantial convex defect involving the absence of calvarial bone as well as more than half of the left hemisphere of the brain, with a profound midline shift and a compression of the ventricular system. There was a severe problem due to multiple deep-skin ulcerations at the depression margin, prone to skin perforation with a probability of intracranial infection. In a first step, a free myocutaneous latissimus dorsi flap was transplanted for volume replacement of the hemispheric brain defect, and 4 months later, artificial bone substitute was implanted in order to prevent progressive vault depression deformity. Healing was uneventful, and the patient showed definite neurological improvement postoperatively. Free tissue transfer can be a valuable option in addition to cranioplasty in the treatment of large bony defects of the skull. Besides providing stable coverage for the reconstructed bone or its substitute, it can also serve as a volume replacement. © 2005 Wiley-Liss, Inc. Microsurgery 25:325,328, 2005. [source]

Functional impairment after latissimus dorsi flap

ANZ JOURNAL OF SURGERY, Issue 1-2 2009
FRACS, Michael Leung MB BS
No abstract is available for this article. [source]

Functional impairment after latissimus dorsi flap

ANZ JOURNAL OF SURGERY, Issue 1-2 2009
Cherry E. Koh
Abstract Background:, Available published reports suggest that loss of latissimus dorsi muscle following latissimus myocutaneous flap does not lead to functional impairment. However, significant functional impairment has been observed in clinical practice, prompting this study to evaluate the functional deficit in patients who had undergone reconstruction using latissimus dorsi muscle. Methods:, A retrospective review was undertaken between 1998 and 2003. Patients were identified from the audit of the plastic surgery unit at St Vincent's Hospital and recruited by direct telephone contact. They were assessed using the Disability of Arm, Shoulder and Hand questionnaire. Results:, There were 25 participants. Eighteen completed their questionnaires. Six of 18 patients reported scores of 30 or more, which corresponded to a global moderate functional deficit. These patients were severely limited in their ability to carry out housework. Major postoperative complications were associated with high Disability of Arm, Shoulder and Hand scores (P = 0.028). Three of five patients involved with sports reported impaired performance in sports. The subgroup of four patients who underwent bilateral latissimus dorsi flaps also experienced significant morbidity with all four reporting moderate to severe impairment in their ability to return to gardening and/or sports. Conclusion:, Patients undergoing this procedure should be fully informed of potential sequelae. Athletic patients and patients undergoing bilateral latissimus dorsi flaps should also be warned of possible reduced performance in sports. Alternatively, perforator cutaneous flaps, which preserve the latissimus muscle, should be chosen when feasible. [source]

Total phalloplasty using a musculocutaneous latissimus dorsi flap

BJU INTERNATIONAL, Issue 4 2007
Sava V. Perovic
Authors from Serbia describe their experience of total phalloplasty in children and adults using a musculocutaneous latissimus dorsi free flap, finding that this method successfully allowed the creation of a neophallus, facilitating subsequent urethroplasty and the safe insertion of a penile prosthesis. In the second article in this section, authors from Finland present the findings in 54 patients relating to skeletal health after intestinal bladder augmentation. OBJECTIVE To present total phalloplasty in children and adults using a musculocutaneous latissimus dorsi (MLD) free flap to create a large neophallus, that allows easy urethroplasty and implantation of a prosthesis. PATIENTS AND METHODS From April 1999 to January 2006, 16 patients (mean age 24 years, range 10,34) had a total phalloplasty; the indications were congenital anomalies of the penis in 12, iatrogenic in two and accidental penile trauma in two. The MLD flap is mobilized on a subscapular artery and vein, and a thoracodorsal nerve. The neophallus is created on-site and after dividing the neurovascular pedicle, transferred to the pubic region, where it is anastomosed with the femoral artery, saphenous vein and ilio-inguinal nerve. The donor site was closed directly in 15 patients while in one a split-thickness skin graft was used to cover the defect. In the following stages, two- or three-stage buccal mucosa urethroplasty was used in 11 patients; a penile prosthesis was implanted in seven. RESULTS The mean (range) follow-up was 31 (12,74) months; the penis was 14,18 cm long and 11,15 cm in circumference. There was no partial or total flap necrosis; the donor site healed satisfactorily in 13 patients while in the remaining three there was moderate scarring. The patency of the urethra was good in all patients. Two urethrocutaneous fistulae developed; one closed spontaneously and the other was successfully treated with minor surgery. The function of the implanted penile prostheses was satisfactory in all patients. CONCLUSIONS The MLD flap allows the creation of a neophallus of good size and with a good aesthetic appearance; it allows urethroplasty and safe implantation of a penile prosthesis, and it can also be used in children. [source]