Reconstructing large defects of the extremities is a challenging problem for reconstructive microsurgeons. The latissimus dorsi musculocutaneous flap (LDMCF) is widely used for this purpose, but a skin graft is needed when the defect is wider than available flaps. We used flow-through divided LDMCFs to reconstruct large defects of the extremities in 5 consecutive patients from 2010 through 2012. The semicircular skin island was split longitudinally, and 1 skin island was advanced over the other to close a round or oval defect without a skin graft. Postoperatively, all flaps survived completely, and the mean Enneking score was 90.0%. The flow-through divided LDMCF is a reliable and versatile option for reconstructing large defects of the extremities.
From the *Division of Plastic and Reconstructive Surgery, National Cancer Center Hospital, Tokyo; and†Division of Plastic and Reconstructive Surgery, National Cancer Center Hospital East, Kashiwa, Japan.
Received February 13, 2013, and accepted for publication, after revision, April 29, 2013.
Conflicts of interest and sources of funding: none declared.
Reprints: Shimpei Miyamoto, MD, Division of Plastic and Reconstructive Surgery, National Cancer Center Hospital, 5-1-1, Tsukiji, Chuo-ku, Tokyo 104-0045, Japan. E-mail: firstname.lastname@example.org.