Muscle Transfers

Abstract

In the late 19th century, Iginio Tansini used skin flaps from the posterior lateral chest to cover mastectomy defects. The distal portion of these flaps always failed. After taking his clinical problem to the anatomy dissection table, he recognized that the skin over the posterior lateral chest wall received its blood supply from branches passing through the latissimus dorsi muscle to the overlying skin [4,9]. This was the first clinical recognition of the concept of muscular perforators’ supplying circulation to the overlying skin. Using this concept, he developed the latissimus dorsi musculocutaneous flap for skin coverage following radical mastectomy. In spite of the discovery of this revolutionary procedure, the musculocutaneous concept did not become understood and accepted until Orticochea described the gracilis musculocutaneous flap. A few years later, the latissimus dorsi was again ‘discovered’ and its tremendous versatility and usefulness appreciated [6].