title: Transplantation of a latissimus dorsi flap between identical twins.
abstract: We present a case of composite tissue transplantation of a latissimus dorsi flap between monozygotic twins. The recipient twin, a 19 year old male, suffered from a complex spinal kyphoscoliosis for which he had undergone multiple previous operations over many years. Soft tissue breakdown on his back causing metalwork exposure had necessitated the removal of his most recent spinal rod. This in turn led to rapid severe deterioration of his spinal deformity and consequent critical impairment of lung function. Robust soft tissue cover was required urgently in order to allow the insertion of a new spinal rod. His previous surgeries and body habitus precluded an adequate autologous reconstruction. Instead, reconstruction using composite tissue transplantation from his identical twin brother was successfully undertaken. We discuss the ethical, psychological and surgical issues involved in this case.
authors.affiliation: Plastic Surgery Department, Norfolk & Norwich University Hospital, Colney Lane, Norwich, NR4 7UY, UK.
authors.forename: M E
authors.initials: ME
authors.lastname: Banwell
authors.forename: J J
authors.initials: JJ
authors.lastname: Clibbon
authors.forename: E M
authors.initials: EM
authors.lastname: Sassoon
mesh_terms: D001415:Back; D004200:Diseases in Twins / Q000523:psychology / Q000601:surgery; D006801:Humans; D008297:Male; D018482:Muscle, Skeletal / Q000637:transplantation*; D013121:Spinal Curvatures / Q000601:surgery*; D013524:Surgical Flaps; D016378:Tissue Transplantation / Q000941:ethics / Q000523:psychology*; D014430:Twins, Monozygotic; D014947:Wounds and Injuries / Q000601:surgery*; D055815:Young Adult