Pedicled Latissimus Dorsi Flap for Complex Arm Defects: A Report of Twenty Cases from Two Centers

Abstract

Introduction: The reconstruction of extensive defects ofthe upper limb are challenging regarding both coverage andfunction. Latissimus dorsi is a suitably located muscle forresurfacing defects in the arm, elbow and forearm especiallywith exposure of the vital structures. It is a large flap, witha long pedicle and can be used as a muscle or musculocutaneousflap.Aim of the Work: Evaluate the role of pedicled latissimusdorsi flap in reconstruction of complex posttraumatic armdefects.Patients and Methods: Pedicled Latissimus dorsi flapswith split thickness skin graft were used to reconstruct 20arm defects. The study were performed in two plastic surgeryunits in Egypt and Kuwait. Overall flap survival and postoperativecomplications were used as outcome measures.Results: None of our flap was totally necrosed. Two cases(10%) developed partial necrosis and partial graft loss occurredin 2 cases (10%). Donor site seroma formation was seen in4 cases (20%). Four cases developed stretching of the scar.Followup ranged from (6-24 months), in which Latissimusdorsi healed perfectly, atrophied and contoured well with acosmetically satisfactory result. No functional deficit developedfrom the loss of the latissimus dorsi.Conclusion: Pedicled latissimus dorsi flap is reliable,versatile, and could be the primary choice for reconstructionof post traumatic large complex arm defects.