Introduction: The reconstruction of extensive defects of
the upper limb are challenging regarding both coverage and
function. Latissimus dorsi is a suitably located muscle for
resurfacing defects in the arm, elbow and forearm especially
with exposure of the vital structures. It is a large flap, with
a long pedicle and can be used as a muscle or musculocutaneous
flap.
Aim of the Work: Evaluate the role of pedicled latissimus
dorsi flap in reconstruction of complex posttraumatic arm
defects.
Patients and Methods: Pedicled Latissimus dorsi flaps
with split thickness skin graft were used to reconstruct 20
arm defects. The study were performed in two plastic surgery
units in Egypt and Kuwait. Overall flap survival and postoperative
complications were used as outcome measures.
Results: None of our flap was totally necrosed. Two cases
(10%) developed partial necrosis and partial graft loss occurred
in 2 cases (10%). Donor site seroma formation was seen in
4 cases (20%). Four cases developed stretching of the scar.
Followup ranged from (6-24 months), in which Latissimus
dorsi healed perfectly, atrophied and contoured well with a
cosmetically satisfactory result. No functional deficit developed
from the loss of the latissimus dorsi.
Conclusion: Pedicled latissimus dorsi flap is reliable,
versatile, and could be the primary choice for reconstruction
of post traumatic large complex arm defects.