[Endoscopically-assisted latissimus dorsi muscle harvest in a young child].
Free tissue transplantation is nowadays regarded as an established method in reconstructive surgery - even in infants. Adequate diameters of vessels for microsurgical anastomosis have been shown in numerous studies. Especially the latissimus dorsi muscle seems to be ideal as a standard flap in this age group. The main disadvantage of this muscle flap lies in its donor-site morbidity with the risk of scar contracture and limitation of shoulder movement. A possible solution to this problem is the endoscopically-assisted harvest of this muscle. A three-year old boy sustained a subtotal amputation of his right heel with consecutive necrosis of soft-tissue. After debridement, a latissimus dorsi-muscle flap was transplanted to cover the defect. The flap was harvested endoscopically-assisted through a single, 2 cm long incision in the left axilla. Healing of the flap was uneventful. At 30 months follow-up the patient showed stable conditions at the right heel without limitations of movement and a hardly visible scar in the left axilla without any noticable growing impairment. Free microvascular muscle-flaps are the treatment of choice in infants with extensive traumatic defects. With the use of minimally invasive operation techniques it is possible to significantly reduce donor-site morbidity and increase therapeutic success even in the youngest patients.
Schoeller
T
T
Universitätsklinik für Plastische und Wiederherstellungschirurgie, Innsbruck, Osterreich. thomas.schoeller@uibk.ac.at
Huemer
G M
GM
Otto-Schoeller
A
A
Wechselberger
G
G
Piza-Katzer
H
H
D000367:Age Factors; D000673:Amputation, Traumatic / Q000601:surgery*; D002675:Child, Preschool; D004724:Endoscopy; D005500:Follow-Up Studies; D018409:Foot Injuries / Q000601:surgery*; D006365:Heel / Q000293:injuries* / Q000601:surgery; D006801:Humans; D008297:Male; D019060:Minimally Invasive Surgical Procedures; D018482:Muscle, Skeletal; D013524:Surgical Flaps; D013997:Time Factors; D020858:Tissue and Organ Harvesting
Endoskopisch-assistierte Hebung der M. latissimus dorsi-Lappenplastik beim Kleinkind.