Anwendungsmöglichkeiten des Musculus latissimus dorsi

Abstract

Anwendungsmöglichkeiten des M. latissimus dorsi bei der Defektdeckung und Rekonstruktion. Auswertung und Beurteilung der Transplantationen in der Nordwestdeutschen Keiferklinik des Universitätsklinikums Hamburg - Eppendorf.

Versatile Use Of The Latissimus Dorsi – Flap

Introduction: Since 1906 the latissimus dorsi – flap has been used in plastic and reconstructive surgery. Tumor extirpation, injury and infection for instance, can result in large defects requiring coverage of allograft – constructs and vital neurovascular strucktures. Due to its reliability, durability and good cosmetic results this flap is still a popular choice for reconstructive matters.

Abstract/ Study: Over a period of eight years 86 latissimus dorsi – flaps have been performed by one surgent at the Universitätsklinikum Hamburg – Eppendorf. This retrospective study evaluates the results of 83 patients who have undergone a latissimus dorsi – flap reconstruction between 1998 and 2006. (The evaluation included reliability , apply, versatility, complications, surgical improvements and the flap surviving – rate of the latissimus dorsi – flap).

There were used 12 pedicled flaps and 74 free flaps. Three of the 83 patients required two flaps. Considering only the free flap there were five patients who required a combined flap. The average of the age was 53,5 years. Tumor extirpation (PEC 50,6%)was the most often reason for defect coverage by flap reconstruction.

Results: Two patients experienced a flap loss (due to arterial insuffizienz and torsion of a vessel). One patient developed a partial flap necrosis which could be prevented by a surgical revision. 20,5% of the patients developed local recurrences. There was an improvement of up to three hours surgical time. (Free flap: 6h 40min. to 3h 40min.) 75% of the flap - reconstruction were undertaken in the area of face and scalf. It could be achieved a flap surviving rate of 97,6%. A revision of flap reconstruction improved from 100% to hardly 0%.

Conclusion: In our study, the latissimus dorsi – flap was an excellent choice for the reconstructions of complex defects within the area of face and heat.