Use of latissimus dorsi flap pedicle as a T-junction to facilitate simultaneous free fibular flap inset in lower extremity salvage
- Title
- Use of latissimus dorsi flap pedicle as a T-junction to facilitate simultaneous free fibular flap inset in lower extremity salvage
- Author
- 김정태
- Keywords
- Bridging flap; Latissimus dorsi free flap; Fibular free flap; Marjolin's ulcer; Tibial reconstruction; T-anastomosis; Branch to serratus anterior
- Issue Date
- 2012-04
- Publisher
- Elsevier SCI Ltd.
- Citation
- JOURNAL OF PLASTIC RECONSTRUCTIVE AND AESTHETIC SURGERY, 2012, 65(4), P.517-520
- 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. (C) 2011 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.
- URI
- http://www.jprasurg.com/article/S1748-6815(11)00497-9/fulltexthttp://hdl.handle.net/20.500.11754/49536
- ISSN
- 1748-6815
- DOI
- 10.1016/j.bjps.2011.08.034
- Appears in Collections:
- COLLEGE OF MEDICINE[S](의과대학) > MEDICINE(의학과) > Articles
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