title: Reconstruction of a large upper tibial wound extending to the knee with a free latissimus dorsi flap: Optimizing the outcomes.
abstract: Despite recent advances in free tissue transfer, management of a large upper tibial wound extending to the knee can be challenging for reconstructive surgeons. In this report, we present two cases where a free latissimus dorsi flap was used for successful soft-tissue coverage of the wound for limb salvage with optimal reconstructive outcomes. Our unique recipient vessel selection allows more effective free-tissue transfer without using a vein graft. Our preferred flap inset technique with multiple interrupted horizontal mattress sutures over a closed suction drain leads to an improvement of the initial contour of soft-tissue coverage that may contribute to the final optimized outcome in the lower-extremity reconstruction with or without a further debulking procedure.
authors.affiliation: Division of Plastic Surgery, University of Kentucky, Lexington, USA.
authors.forename: James E
authors.initials: JE
authors.lastname: Liau
authors.forename: Lee L Q
authors.initials: LL
authors.lastname: Pu
mesh_terms: D000328:Adult; D016025:Bone Transplantation; D005599:Fractures, Ununited / Q000601:surgery; D006801:Humans; D007718:Knee Injuries / Q000601:surgery*; D023821:Limb Salvage; D008297:Male; D008866:Microsurgery; D009336:Necrosis; D054843:Negative-Pressure Wound Therapy; D011150:Popliteal Artery / Q000601:surgery; D011152:Popliteal Vein / Q000601:surgery; D011183:Postoperative Complications / Q000601:surgery*; D012086:Reoperation; D017695:Soft Tissue Injuries / Q000601:surgery*; D013524:Surgical Flaps / Q000098:blood supply*; D013536:Suture Techniques; D013978:Tibial Fractures / Q000601:surgery*