title: The latissimus dorsi perforator-based fasciocutaneous flap.
abstract: The latissimus dorsi musculocutaneous flap has proven utility in the reconstruction of defects of the breast, chest wall, head and neck, and upper extremity. As a free flap, the latissimus dorsi has become a mainstay for the coverage of severe traumatic tibial/ fibular wounds. We describe a new and useful extension of the latissimus dorsi musculocutaneous unit that consists of a fasciocutaneous segment based on musculocutaneous perforators from the thoracodorsal artery. The vascular anatomy of the flap is described and illustrated with 6 fresh human cadaveric dissections. We also present 3 cases in which in vivo dissections of this flap were performed, 2 at the time of latissimus microvascular transfer and 1 approximately 5 days after microvascular transfer to salvage exposed fractured tibial bone successfully due to distal muscle loss. A pedicled or free latissimus dorsi musculocutaneous flap may be reliably extended and thereby rendered more versatile through the use of the perforator-based fasciocutaneous flap. Benefits and potential applications of the latissimus dorsi perforator-based fasciocutaneous flap are discussed.
authors.affiliation: Cornell University Medical College, New York, NY, USA.
authors.forename: H M
authors.initials: HM
authors.lastname: Spinelli
authors.forename: J A
authors.initials: JA
authors.lastname: Fink
authors.forename: A R
authors.initials: AR
authors.lastname: Muzaffar
mesh_terms: D002648:Child; D006801:Humans; D007866:Leg / Q000601:surgery*; D008297:Male; D018482:Muscle, Skeletal / Q000601:surgery*; D013524:Surgical Flaps