We have used 9 free latissimus dorsi myocutaneous flaps. All but 1 survived completely. This one showed superficial necrosis at the flap margin. Our operative techniques and experiences are reported here, with some of our results.
A relatively large flap can be nourished by only one vascular pedicle, the subscapular-thoracodorsal vessels. Though there are many vascular variations in the axillary region, the subscapular-thoracodorsal vessels are easily identifiable in our experience, and their diameters are always large enough for microvascular anastomosis. The buld of this flap is one of its important features. Care must be taken in the design of the flop so that it fits exactly, and it should also be remembered that the volume of the flap will decrease greatly later on. The flap is remarkably simple, safe, and reliable. We believe it will be the method of choice in many microsurgical cases.
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