Latissimus dorsi flaps oriented on the lateral intercostal artery perforators

Anatomical study and application in autologous breast reconstruction

Toshiharu Minabe, Kiyonori Harii, Nobuaki Imanishi

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Autologous breast reconstruction with the latissimus dorsi (LD) musculocutaneous flap has several problems including scarcity of tissue and postoperative atrophy of muscles. We report a modification of the flap based on a re-evaluation of the intramuscular and perforating vascular anatomy focused on the intercostal vascular system. Our anatomical study confirmed the following technical improvements: splitting of the muscle oriented along the 10 th posterior intercostal artery; siting the axis of the flap on the centre of the 10th lateral intercostal artery perforator to obtain ample subcutaneous fat cranial to the iliac crest; and enclosing the dermoadipofascial flap around the split muscular pedicle. These flaps were used in 12 patients who required reconstruction without implants. The results showed a consistent volume of tissue and shape, and less donor site morbidity. Our modifications can be used to improve the three-dimensional potential of the LD flap in autologous breast reconstruction.

Original languageEnglish
Pages (from-to)58-65
Number of pages8
JournalJournal of Plastic Surgery and Hand Surgery
Volume45
Issue number2
DOIs
Publication statusPublished - 2011 Apr

Fingerprint

Superficial Back Muscles
Mammaplasty
Blood Vessels
Arteries
Myocutaneous Flap
Muscular Atrophy
Subcutaneous Fat
Anatomy
Tissue Donors
Morbidity
Muscles

Keywords

  • Angiographic study
  • autologous breast reconstruction
  • flap extension
  • Lateral intercostal artery perforator
  • latissimus dorsi flap
  • muscle splitting
  • perforator mapping

ASJC Scopus subject areas

  • Surgery

Cite this

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abstract = "Autologous breast reconstruction with the latissimus dorsi (LD) musculocutaneous flap has several problems including scarcity of tissue and postoperative atrophy of muscles. We report a modification of the flap based on a re-evaluation of the intramuscular and perforating vascular anatomy focused on the intercostal vascular system. Our anatomical study confirmed the following technical improvements: splitting of the muscle oriented along the 10 th posterior intercostal artery; siting the axis of the flap on the centre of the 10th lateral intercostal artery perforator to obtain ample subcutaneous fat cranial to the iliac crest; and enclosing the dermoadipofascial flap around the split muscular pedicle. These flaps were used in 12 patients who required reconstruction without implants. The results showed a consistent volume of tissue and shape, and less donor site morbidity. Our modifications can be used to improve the three-dimensional potential of the LD flap in autologous breast reconstruction.",
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