Salvage Operation of Head and Neck Reconstruction Using a Pedicled Latissimus Dorsi Myocutaneous Flap with Distally Positioned Skin Paddle.

IF 1.5 Q3 SURGERY Plastic and Reconstructive Surgery Global Open Pub Date : 2024-10-11 eCollection Date: 2024-10-01 DOI:10.1097/GOX.0000000000006199

Tsubasa Kojima, Hisashi Motomura, Ayaka Nochi Deguchi, Shusaku Maeda, Songsu Kang

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Abstract

Background: There are many situations in head and neck reconstruction where a pedicled flap must be chosen over free flaps. In such situations, one of our options is a pedicled latissimus dorsi (LD) myocutaneous flap with distally positioned skin paddle with a more distal skin flap design.

Methods: We performed 22 reconstruction cases using a distally positioned pedicled LD myocutaneous flap. When designing the skin paddle more distally than usual, it is important to include the lateral cutaneous branch of the 10th posterior intercostal artery. By splitting the skin paddle sections, the LD flap is flexible for use in complex head and neck defects. It can also be used for mandibular reconstruction by harvesting the flap with costal bone.

Results: In all cases, the skin flaps survived, with a salvage rate of 100%.

Conclusions: Because elevation of this flap is relatively easy, safe, and quick, this flap selection is considered practical in salvage cases after flap necrosis, and in cases after multiple procedures.

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使用带远端定位皮瓣的足底背阔肌肌皮瓣进行头颈部重建的抢救性手术

背景：在头颈部重建的许多情况下，必须选择带蒂皮瓣而不是游离皮瓣。在这种情况下，背阔肌（LD）肌皮瓣与远端定位的皮瓣桨是我们的选择之一：我们使用远端定位的带蒂背阔肌（LD）肌皮瓣进行了22例重建手术。在设计比通常更远的皮瓣时，必须包括第 10 肋间后动脉的外侧皮支。通过分割皮瓣部分，LD皮瓣可灵活用于复杂的头颈部缺损。通过与肋骨一起采集皮瓣，它还可用于下颌骨重建：结果：在所有病例中，皮瓣都存活了下来，挽救率达 100%：由于这种皮瓣的提升相对简单、安全、快速，因此在皮瓣坏死后的抢救病例和多次手术后的病例中，这种皮瓣的选择被认为是实用的。

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来源期刊

Plastic and Reconstructive Surgery Global Open SURGERY-

CiteScore

2.20

自引率

13.30%

发文量

1584

审稿时长

10 weeks

期刊介绍： Plastic and Reconstructive Surgery—Global Open is an open access, peer reviewed, international journal focusing on global plastic and reconstructive surgery.Plastic and Reconstructive Surgery—Global Open publishes on all areas of plastic and reconstructive surgery, including basic science/experimental studies pertinent to the field and also clinical articles on such topics as: breast reconstruction, head and neck surgery, pediatric and craniofacial surgery, hand and microsurgery, wound healing, and cosmetic and aesthetic surgery. Clinical studies, experimental articles, ideas and innovations, and techniques and case reports are all welcome article types. Manuscript submission is open to all surgeons, researchers, and other health care providers world-wide who wish to communicate their research results on topics related to plastic and reconstructive surgery. Furthermore, Plastic and Reconstructive Surgery—Global Open, a complimentary journal to Plastic and Reconstructive Surgery, provides an open access venue for the publication of those research studies sponsored by private and public funding agencies that require open access publication of study results. Its mission is to disseminate high quality, peer reviewed research in plastic and reconstructive surgery to the widest possible global audience, through an open access platform. As an open access journal, Plastic and Reconstructive Surgery—Global Open offers its content for free to any viewer. Authors of articles retain their copyright to the materials published. Additionally, Plastic and Reconstructive Surgery—Global Open provides rapid review and publication of accepted papers.