title: Skin grafted latissimus dorsi flap for reconstruction of lateral aesthetic units of the face.
abstract: Reconstruction of large defects of the lateral region of the face is rather challenging due to the unique color, texture, and thickness of soft tissues in this area. Microsurgical free flaps represent the gold standard, providing superior functional and aesthetic restoration. Purpose of this study was to assess reliability of skin-grafted latissimus dorsi (LD) flap, for a pleasant and symmetric reconstruction of the lateral aesthetic units of the face compared to a control group of patients addressed to perforator flaps. From November 2008 to June 2012, 5 patients underwent skin-grafted LD flap reconstruction of defects involving the lateral aesthetic units of the face, with 8.1 ± 0.5 × 9.7 ± 1.3 cm mean size. A 1-to-4 Likert scale was used to assess skin color, texture, shape, and bulkiness. Using the Pressure-Specified Sensory Device epicritic, proprioceptive, and protopathic sensitivities were tested. Outcomes were compared with those of a control group of 5 patients addressed to reconstruction with perforator flaps (3 anterolateral thigh flap, 2 vertical deep inferior perforator flap). At mean 21-month follow-up all flaps healed uneventfully without need for revisions, all developing more satisfactory results in terms of skin color (P = 0.028) and texture (P = 0.021) match, shape (P = 0.047) and bulkiness (P = 0.012) compared with perforator flaps. No differences in epicritic, proprioceptive, and protopathic sensitivities were observed (P > 0.05) between the two groups. Skin-grafted LD flap may be a suitable option for reconstruction of wide defects of the lateral aesthetic units of the face.
authors.affiliation: Plastic Surgery Unit, NESMOS Department, Sant'Andrea Hospital, School of Medicine and Psychology, "Sapienza" University of Rome, Italy.
authors.forename: Benedetto
authors.initials: B
authors.lastname: Longo
authors.forename: Rosaria
authors.initials: R
authors.lastname: Laporta
authors.forename: Marco
authors.initials: M
authors.lastname: Pagnoni
authors.forename: Antonella
authors.initials: A
authors.lastname: Campanale
authors.forename: Francesca Romana
authors.initials: FR
authors.lastname: Grippaudo
authors.forename: Fabio
authors.initials: F
authors.lastname: Santanelli Di Pompeo
mesh_terms: D000328:Adult; D000368:Aged; D004954:Esthetics; D005145:Face / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D058752:Free Tissue Flaps / Q000637:transplantation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D061525:Perforator Flap; D019651:Plastic Surgery Procedures / Q000379:methods*; D015203:Reproducibility of Results; D016038:Skin Transplantation / Q000379:methods; D064171:Superficial Back Muscles / Q000637:transplantation*