Use of latissimus dorsi flap pedicle as a T-junction to facilitate simultaneous free fibular flap inset in lower extremity salvage
- Authors
- Hwang, Kyu Tae; Youn, Seungki; Kim, Jeong Tae; Lee, Seung Hoon; Ng, Siew-Weng; Kim, Youn Hwan
- Issue Date
- Apr-2012
- Publisher
- ELSEVIER SCI LTD
- Keywords
- Bridging flap; Latissimus dorsi free flap; Fibular free flap; Marjolin' s ulcer; Tibial reconstruction; T-anastomosis; Branch to serratus anterior muscle
- Citation
- JOURNAL OF PLASTIC RECONSTRUCTIVE AND AESTHETIC SURGERY, v.65, no.4, pp.517 - 520
- Indexed
- SCIE
SCOPUS
- Journal Title
- JOURNAL OF PLASTIC RECONSTRUCTIVE AND AESTHETIC SURGERY
- Volume
- 65
- Number
- 4
- Start Page
- 517
- End Page
- 520
- URI
- https://scholarworks.bwise.kr/hanyang/handle/2021.sw.hanyang/165940
- DOI
- 10.1016/j.bjps.2011.08.034
- ISSN
- 1748-6815
- Abstract
- Marjolin's ulcer is a very aggressive form of squamous cell carcinoma arising from chronic wounds or unstable scars. A resection margin of at least 2 cm with clear deep margin is required on removal. A 79-year-old male presented with chronic osteomyelitis of the left anterior tibial region with chronic ulceration. Biopsy revealed squamous cell carcinoma. The tumour, measuring 8 cm, was resected with surrounding unstable scar tissue including en bloc resection of the involved tibial bone, leaving the posterior cortex. Reconstruction was done with a fibular free flap from the contralateral side, but the pedicle length was too short to reach the anterior tibial vessels. To bridge the vascular gap, and to cover the soft-tissue defect, a latissimus dorsi free flap was harvested using the muscle-sparing method. The thoracodorsal vessels were used as an interpositional graft to anastomose the peroneal vessels of the fibular flap. The patient was ambulatory by 4 months, and complete bone union was seen after 6 months. During the 18-month follow-up period, there was no evidence of recurrence.
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