The Use of Latissimus Dorsi Free Flap

Abstract

The free latissimus dorsi flap covers large defects involving the skin, malar, mandible, temporal and sphenoid bone, external and medium ear and zygomatic arch. The muscle is very helpful to isolate the epidural space from the surrounding tissue. In cases a neck dissection is demanded, vessels for the flap anastomosis should be already prepared, shortening the surgery time. By connecting the thoracodorsal nerve to the facial nerve, a facial reanimation is possible. For reconstructions in the area of the head, it is preferable to change the classical positioning of the patient from a prone or supine decubitus to a position allowing elevation of the flap by a second team at the same time with the tumour excision. On the other hand, the flap can be too bulky compared to the volume of the defect, especially in those cases with an association between an important surface and a relative superficial defect. Additionally, there are differences between the skin texture of the flap and of the facial skin.