title: Technical refinements of composite thoracodorsal system free flaps for 1-stage lower extremity reconstruction resulting in reduced donor-site morbidity.
abstract: A multitude of local flaps has been suggested for lower extremity reconstruction. However, the gold standard for defect coverage remains free tissue transfer. In this regard, the scapular vascular axis is a well-established source of expendable skin, fascia, muscle, and bone for use in free flap reconstruction of defects requiring bone and soft tissue in complex 3-dimensional relationships. Composite bone and soft-tissue flaps derived from the subscapular vascular axis include the osteocutaneous scapular flap, the "latissimus/bone flap," and the thoracodorsal artery perforator-scapular osteocutaneous flap.Patient outcome following reconstruction of lower extremity defects with composite free flaps from the thoracodorsal system were analyzed. Here, we demonstrate the execution of technical refinements on free composite flap transfers based on the thoracodorsal vascular axis, thus resulting in a stepwise reduction of donor-site morbidity.
authors: Department of Plastic and Hand Surgery, University of Freiburg Medical Center, Freiburg, Germany. holger.bannasch@uniklinik-freiburg.de
authors: Holger
authors: H
authors: Bannasch
authors: Peter C
authors: PC
authors: Strohm
authors: Khalid
authors: K
authors: Al Awadi
authors: G Björn
authors: GB
authors: Stark
authors: Arash
authors: A
authors: Momeni
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005360:Fibula / Q000293:injuries*; D050723:Fractures, Bone / Q000601:surgery*; D006801:Humans; D007869:Leg Injuries / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019651:Plastic Surgery Procedures; D017695:Soft Tissue Injuries / Q000601:surgery*; D013524:Surgical Flaps; D013978:Tibial Fractures / Q000601:surgery*; D016896:Treatment Outcome