The Latissimus Dorsi Flap: Understanding the Basics

Description

The latissimus dorsi flap is highlighted as a crucial component in reconstructive surgery, being utilized for over twenty years due to its size, versatility, and reliable blood supply. Originating within the subscapular system, this flap can be modified in size and shape, reaching dimensions up to 20 by 30 cm, making it one of the largest flaps available. Its adaptations allow for both muscle and skin coverage, enabling complex defects to be addressed effectively.



The latissimus dorsi's anatomy is meticulously detailed, with blood supply primarily from the thoracodorsal artery, which is stable and ensures adequate nourishment. Various techniques for flap design, including different combinations with adjacent tissue, expand its usability in reconstructive operations.



In surgical procedures, careful planning starts with marking anatomical landmarks, such as the scapula and iliac crest. The specific surgical case presented involves a near-complete proximal humerus reconstruction, illustrating the intricacies of tunneling techniques and flap design based on the existing scar tissue. Collaboration between the latissimus muscle and additional structures in the shoulder region underscores the importance of anatomical familiarity for optimal outcomes.



The dissection process is documented step-by-step, ensuring that major vessels are identified and preserved while maintaining muscle integrity. Ultimately, the operation culminates with achieving satisfactory coverage over the reconstructed area, with the possibility of modifying the skin paddle if necessary. The procedure concludes with encouraging post-operative outcomes, showcasing the patient’s recovery.

Specialties