Latissimus dorsi myocutaneous flap
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At the time the article was created David Chang had no recorded disclosures.View David Chang's current disclosures
At the time the article was last revised Yuranga Weerakkody had no recorded disclosures.View Yuranga Weerakkody's current disclosures
A latissimus dorsi myocutaneous flap is a form of breast reconstruction that transplants the patient’s own latissimus dorsi muscle, fat, and skin from the middle back to the chest to form a breast mound.
This flap is more easily created and contains a robust vascular supply compared to other flaps such as transverse rectus abdominis musculocutaneous (TRAM) flap or deep inferior epigastric perforator (DIEP) flap reconstruction. Therefore, it is commonly used if a previous flap has failed 1.
A latissimus dorsi flap also causes less patient morbidity as it does not weaken the abdominal wall.
A latissimus dorsi myocutaneous flap produces a less pleasing aesthetic result when compared to transverse rectus abdominis musculocutaneous and deep inferior epigastric perforator flap reconstructions. It commonly requires an implant to achieve symmetry or a pleasing aesthetic result.
It leaves a large scar in the middle of the back and commonly is complicated by a postoperative seroma.
It causes a temporary 15-20% reduction in shoulder strength 2.
Rotated and tunneled latissimus dorsi muscle gives a tailed appearance to the reconstruction 2.
The denuded dermal layer is seen parallel to the skin of the breast.
- postoperative seroma at donor site. Some report upwards of >95% of patients developing a postoperative seroma 3.
- postoperative wound infection
- postoperative hematoma
- wound dehiscence
- flap necrosis
- chronic back pain