title: Efficient design of a latissimus dorsi musculocutaneous flap to repair large skin defects of the upper back.
abstract: Closing large skin defects of the upper back is a challenging problem. We have developed an efficient design for a latissimus dorsi musculocutaneous flap for reconstruction in this region. The longitudinal axis of the skin island was designed to be perpendicular to the line of least skin tension at the recipient site so that primary closure of the flap donor site changed the shape of the recipient site to one that was easier to close. We used this method for four patients with skin cancers or soft-tissue sarcomas of the upper back in 2011 and 2012. The size of skin defects after wide excision ranged from 11 × 10 to 25 × 20 cm(2) , and all skin defects could be covered by the flaps and all wounds of donor site could be closed without skin grafts. No wound complications occurred in any patient. Functional and aesthetic outcomes were satisfactory in all patients. This flap design is effective for reconstructing large skin defects of the upper back.
authors.affiliation: Division of Plastic and Reconstructive Surgery, National Cancer Center Hospital, Tokyo, Japan.
authors.forename: Shimpei
authors.initials: S
authors.lastname: Miyamoto
authors.forename: Shuji
authors.initials: S
authors.lastname: Kayano
authors.forename: Hiroki
authors.initials: H
authors.lastname: Umezawa
authors.forename: Masahide
authors.initials: M
authors.lastname: Fujiki
authors.forename: Junichi
authors.initials: J
authors.lastname: Nakao
authors.forename: Minoru
authors.initials: M
authors.lastname: Sakuraba
mesh_terms: D000328:Adult; D000368:Aged; D001415:Back; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D064827:Myocutaneous Flap; D019651:Plastic Surgery Procedures / Q000379:methods*; D012878:Skin Neoplasms / Q000601:surgery*; D014945:Wound Healing