title: Muscle-sparing latissimus dorsi myocutaneous flap with maintenance of muscle innervation, function, and aesthetic appearance of the donor site.
abstract: In this report, the authors describe the application of a muscle-sparing technique to harvest a myocutaneous latissimus dorsi muscle flap, including only a tiny lateral muscle segment but carrying a large skin paddle, with the advantage of leaving intact innervation and function of the remaining latissimus dorsi muscle. According to the experiences and complications associated with the pure thoracodorsal artery perforator harvest at the authors' institution, the necessity of increasing the reliability of the vascular pedicle demands that a small muscle strip be left embedding the perforator vessels attached to the skin paddle. This procedure was applied in eight cases with only one minor complication, which was a distal flap tip necrosis in the largest flap used. The muscle function and aesthetic contour of the posterior axillary fold were preserved in every case. Harvesting a large skin paddle flap that is carried by a diminutive longitudinal segment of latissimus dorsi muscle circumvents thoracodorsal nerve damage and maintains muscle function. In contrast to a thoracodorsal artery perforator flap without muscle, the harvesting of which is a delicate procedure, this procedure is regarded as easier and safer.
authors.affiliation: Department of Plastic and Reconstructive Surgery, University of Innsbruck, and Ludwig-Boltzmann-Institute for Quality Control in Plastic Surgery, Innsbruck, Austria. anton.schwabegger@uibk.ac.at
authors.forename: Anton H
authors.initials: AH
authors.lastname: Schwabegger
authors.forename: Christoph
authors.initials: C
authors.lastname: Harpf
authors.forename: Christian
authors.initials: C
authors.lastname: Rainer
mesh_terms: D000293:Adolescent; D000328:Adult; D001415:Back; D004954:Esthetics; D005121:Extremities / Q000601:surgery; D005260:Female; D006801:Humans; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000294:innervation / Q000637:transplantation; D009333:Neck / Q000601:surgery; D019651:Plastic Surgery Procedures / Q000379:methods*; D013524:Surgical Flaps / Q000098:blood supply / Q000294:innervation*; D020858:Tissue and Organ Harvesting / Q000379:methods*