The reverse latissimus dorsi flap: An anatomical study and retrospective analysis of its clinical application

Raimund Winter, M. Steinböck, W. Leinich, F. M. J. Reischies, G Feigl, M Sljivich, Herwig Friedl, M. Hubmer, H. Koch

Publikation: Beitrag in einer FachzeitschriftArtikelForschungBegutachtung

Abstract

The segmental paraspinous and intercostal blood vessels form the blood supply and represent the pivot point for the reverse latissimus dorsi flap. Aim of this study was to confirm the exact location of the blood supply and the most caudal pivot point to assess the suitability of the reverse latissimus dorsi flap for pedicled reconstructions of the trunk as well as sacral area. Our study comprised a human cadaver study, where 30 latissimus dorsi flaps were assessed in 15 specimens, and a clinical study with 49 patients who underwent distally based latissimus dorsi flap reconstructions in our division. 74% of all perforators were located in a bilateral 7 cm broad area, which spread from the 6th intercostal space to the subcostal plane. In a second clinical part of this study we evaluated forty-nine patients, who underwent reconstruction with the reverse latissimus dorsi flap. We demonstrated that the pivot point can also be planned below the 12th rib, thus reaching tissue defects in the sacral area. To the best of our knowledge, this is the first study to define a caudal "hotspot" for the safest blood supply of the reverse latissimus dorsi flap.
Originalspracheenglisch
Seiten (von - bis)1084-1090
FachzeitschriftJournal of Plastic, Reconstructive & Aesthetic Surgery
Jahrgang72
Ausgabenummer7
DOIs
PublikationsstatusVeröffentlicht - Jul 2019

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The reverse latissimus dorsi flap: An anatomical study and retrospective analysis of its clinical application. / Winter, Raimund; Steinböck, M. ; Leinich, W.; Reischies, F. M. J. ; Feigl, G; Sljivich, M; Friedl, Herwig; Hubmer, M.; Koch, H.

in: Journal of Plastic, Reconstructive & Aesthetic Surgery, Jahrgang 72, Nr. 7, 07.2019, S. 1084-1090.

Publikation: Beitrag in einer FachzeitschriftArtikelForschungBegutachtung

Winter, Raimund ; Steinböck, M. ; Leinich, W. ; Reischies, F. M. J. ; Feigl, G ; Sljivich, M ; Friedl, Herwig ; Hubmer, M. ; Koch, H. / The reverse latissimus dorsi flap: An anatomical study and retrospective analysis of its clinical application. in: Journal of Plastic, Reconstructive & Aesthetic Surgery. 2019 ; Jahrgang 72, Nr. 7. S. 1084-1090.
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abstract = "The segmental paraspinous and intercostal blood vessels form the blood supply and represent the pivot point for the reverse latissimus dorsi flap. Aim of this study was to confirm the exact location of the blood supply and the most caudal pivot point to assess the suitability of the reverse latissimus dorsi flap for pedicled reconstructions of the trunk as well as sacral area. Our study comprised a human cadaver study, where 30 latissimus dorsi flaps were assessed in 15 specimens, and a clinical study with 49 patients who underwent distally based latissimus dorsi flap reconstructions in our division. 74{\%} of all perforators were located in a bilateral 7 cm broad area, which spread from the 6th intercostal space to the subcostal plane. In a second clinical part of this study we evaluated forty-nine patients, who underwent reconstruction with the reverse latissimus dorsi flap. We demonstrated that the pivot point can also be planned below the 12th rib, thus reaching tissue defects in the sacral area. To the best of our knowledge, this is the first study to define a caudal {"}hotspot{"} for the safest blood supply of the reverse latissimus dorsi flap.",
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AU - Feigl, G

AU - Sljivich, M

AU - Friedl, Herwig

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AB - The segmental paraspinous and intercostal blood vessels form the blood supply and represent the pivot point for the reverse latissimus dorsi flap. Aim of this study was to confirm the exact location of the blood supply and the most caudal pivot point to assess the suitability of the reverse latissimus dorsi flap for pedicled reconstructions of the trunk as well as sacral area. Our study comprised a human cadaver study, where 30 latissimus dorsi flaps were assessed in 15 specimens, and a clinical study with 49 patients who underwent distally based latissimus dorsi flap reconstructions in our division. 74% of all perforators were located in a bilateral 7 cm broad area, which spread from the 6th intercostal space to the subcostal plane. In a second clinical part of this study we evaluated forty-nine patients, who underwent reconstruction with the reverse latissimus dorsi flap. We demonstrated that the pivot point can also be planned below the 12th rib, thus reaching tissue defects in the sacral area. To the best of our knowledge, this is the first study to define a caudal "hotspot" for the safest blood supply of the reverse latissimus dorsi flap.

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