title: Vascular augmentation of an extended latissimus dorsi myocutaneous flap through an intercostal vessel: a preliminary report.
abstract: The extended latissimus dorsi (LD) flap, which includes adipofascial tissue around the posterior iliac crest, is a good option to reconstruct a large breast. However, poor vascularity in the extended part may cause partial fat necrosis. To minimise this problem, vascular augmentation of the extended adipofascial part was performed. When dissecting under the LD muscle, a single perforator from the 11th intercostal vessels was secured and traced upwards along the rib. After the flap was transferred to the chest, the intercostal vessels were anastomosed to the serratus branches of thoracodorsal vessels. This vascular supercharged extended LD flap technique was applied for selected patients. Intraoperative angiography showed that the contrast medium injected into the intercostal artery spread across the lumbar adipofascial part of the flap. This implies that vascular supercharge through the 11th intercostal vessel promotes the vascularity of the extended LD flap and may help to reduce the flap complication rate.
authors: Department of Plastic, Reconstructive, and Aesthetic Surgery, School of Medicine, Fukuoka University, Fukuoka, Japan. stakagi@fukuoka-u.ac.jp
authors: Satoshi
authors: S
authors: Takagi
authors: Takuto
authors: T
authors: Oyama
authors: Kenji
authors: K
authors: Yamazumi
authors: Akiko
authors: A
authors: Eto
authors: Hiroyuki
authors: H
authors: Ohjimi
mesh_terms: D000368:Aged; D000714:Anastomosis, Surgical / Q000379:methods; D000792:Angiography; D005260:Female; D006801:Humans; D016462:Mammaplasty / Q000379:methods*; D016343:Monitoring, Intraoperative / Q000379:methods; D018482:Muscle, Skeletal / Q000098:blood supply / Q000637:transplantation; D012272:Ribs / Q000098:blood supply; D025321:Surgery, Computer-Assisted / Q000379:methods; D013524:Surgical Flaps / Q000098:blood supply*