PR13 THE USE OF PEDICLED LATISSIMUS DORSI FLAPS IN LARGE CHEST WALL RECONSTRUCTION

Abstract

Purpose to report a challenging case of reconstructing a massive chest wall defect. To demonstrate the usefulness of the pedicled latissimus dorsi flap to reconstruct massive sternal wounds.Methodology Case Report – A 35 year old man presented 2 weeks after a chest wall resection for a primary amyloidoma and reconstruction using a combination of a titanium mesh and Gore‐tex soft tissue patch with primary skin closure. He was clinically septic, with the primary focus being the chest wound. The infected Gore‐tex and titanium mesh were removed, and the cavity debrided, resulting in a chest wall defect measuring 30 cm (subcutaneous width) × 20 cm (height) and a bony defect measuring 15 cm (width) × 18 cm (height). An initial attempt of reconstructing this with a free latissimus dorsi flap was abandoned prior to raising of the flap because of difficulty in finding a recipient vessel. The defect was finally reconstructed using a pedicled latissimus dorsi flap.Result We describe a single stage technique for reconstructing a massive sternal defect. The use of a pedicled latissimus dorsi flap provided a reliable reconstruction in what can be a traditionally difficult reconstructive site.Conclusion A pedicled latissimus dorsi flap is useful even in the reconstruction of large chest wall defects.