A comparison of the cutaneous trunci myocutaneous flap and latissimus dorsi myocutaneous flap in the dog.

Abstract

Latissimus dorsi and cutaneous trunci myocutaneous flaps of equal dimension and location were randomly elevated on opposite sides of the thorax in 10 dogs (group 1) and resutured to their respective bed. The procedure was repeated in four additional dogs (group 2); however, the short perforating branches of the thoracodorsal artery and vein were divided at the base of each cutaneous trunci myocutaneous flap, whereas the cutaneous pedicle and underlying cutaneous trunci muscle were divided in the latissimus dorsi myocutaneous flaps to determine subsequent skin survivability and the major source of circulation of each myocutaneous flap. There was little difference in the percentage of skin survival between the latissimus dorsi and cutaneous trunci myocutaneous flaps in group 1 dogs. Circulation to the "skin island" of group 2 latissimus dorsi myocutaneous flaps originated from intramuscular anastomotic connections between the major branch of the thoracodorsal artery entering the latissimus dorsi muscle and the proximal lateral intercostal arteries perforating the muscle. Ligation of the short perforating branches of the thoracodorsal artery resulted in partial skin necrosis in all group 2 cutaneous trunci myocutaneous flaps. Results from this study indicate that it is unnecessary to elevate the latissimus dorsi muscle for major skin flap elevation and survival. The thicker latissimus dorsi myocutaneous flap is more difficult to develop surgically and appears to have no clinical major advantage over the more mobile cutaneous trunci myocutaneous flap or the adjacent thoracodorsal axial pattern flap for closure of large skin defects within the radius of flap rotation.