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An Anatomic Study of the Latissimus DorsiRib Flap: An Extension of the Subscapular Combined Flap

Yamamoto, Yuhei M.D., Ph.D.; Sugihara, Tsuneki M.D., Ph.D.; Kawashima, Kunihiro M.D.; Qi, Fazhi M.D.

Plastic and Reconstructive Surgery: October 1996 - Volume 98 - Issue 5 - p 811–816
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The anatomy of the vascular perforators between the latissimus branch of the thoracodorsal vessels and the lateral branch of the dorsal rami of the intercostal vessels was studied in a series of 10 dissections in 5 preserved cadavers to develop the latissimus dorsi myocutaneous flap combined with a vascularized rib. The distances between the communicating perforators and the spinous process and the iliac cirest, which become a good guide for design of the rib flap, were measured. An extension of the combined flap including the scapular osteocutaneous flap, latissimus dorsi myocutaneous flap, and vascularized eleventh and twelfth ribs that is nourished by a “single” subscapular vascular system was demonstrated. This technique, which provides a large amount of skin, muscle, and bone, is very effective for reconstruction of an extended composite maxillary and mandibular defect. (Plast. Reconstr. Surg. 98: 811, 1996.)

Sapporo, Japan

From the Department of Plastic and Reconstructive Surgery at the School of Medicine of Hokkaido University. Received for publication July 10, 1995; revised November 10, 1995.

Yuhei Yamamoto, M.D.

Department of Plastic and Reconstructive Surgery

Hokkaido University, School of Medicine

Kita 15, Nishi 7, Kitaku.

Sapporo, 060, Japan

©1996American Society of Plastic Surgeons