Latissimus Dorsi Flap for Leg Reconstruction

Variants of the latissimus dorsi flap are quite versatile and offer multiple reconstructive options for creative surgeons. The latissimus dorsi flap may be raised as a muscle flap or together with the overlying skin as a musculocutaneous unit. Apart from its use as a pedicled flap or for microvascular free flap transfer, the latissimus dorsi can be raised with portions of ribs and may include the serratus anterior muscle. Different customized chimeric (muscle and perforator flap) or perforator flap techniques find application for repair difficult with large three-dimensional defects or when large and thin, skin-only tissue is needed, respectively. Different designs of the flap, dissection techniques, and flap variant applications in the context of a systematic approach to reconstructive problems are described.