Pre-expanded Muscle-sparing Latissimus Dorsi Flaps for Reconstruction of Severe Scar Contractures on the Anterior Chest
ABSTRACT: Objective: To investigate the utility of pre-expanded muscle-sparing latissimus dorsi flaps in the reconstruction of deformities secondary to severe scar contractures on the anterior chest. Methods: The function of the latissimus dorsi was preserved with blood supply from the main or late...
Ausführliche Beschreibung
Gespeichert in:
| Autor*in: |
Zhichao WANG [verfasserIn] Dujuan LIU [verfasserIn] Shuchen GU [verfasserIn] Baoxiang TIAN [verfasserIn] Tao ZAN [verfasserIn] Bin GU [verfasserIn] |
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| Format: |
E-Artikel |
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| Sprache: |
Englisch |
| Erschienen: |
2020 |
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| Schlagwörter: |
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| Übergeordnetes Werk: |
In: Chinese Journal of Plastic and Reconstructive Surgery - KeAi Communications Co. Ltd., 2022, 2(2020), 2, Seite 6377-68 |
|---|---|
| Übergeordnetes Werk: |
volume:2 ; year:2020 ; number:2 ; pages:6377-68 |
| Links: |
|---|
| DOI / URN: |
10.1016/S2096-6911(21)00014-5 |
|---|
| Katalog-ID: |
DOAJ024868884 |
|---|
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| 520 | |a ABSTRACT: Objective: To investigate the utility of pre-expanded muscle-sparing latissimus dorsi flaps in the reconstruction of deformities secondary to severe scar contractures on the anterior chest. Methods: The function of the latissimus dorsi was preserved with blood supply from the main or lateral branch of the thoracodorsal artery. The entire treatment period was divided into two stages, during which segmental latissimus dorsi flaps were pre-expanded in stage I and anterior chest scar deformities were reconstructed in stage II.During stage I, the musculocutaneous perforators arising from the lateral branch of the thoracodorsal artery were determined by ultrasound preoperatively; the flap design included the anterior segment of the latissimus dorsi supplied by the musculocutaneous perforators from the lateral branch; and a tissue expander was placed following flap dissection and then infused with saline intermittently for 4–6 months.In stage II, the chest scars were excised, and breast tissues were repositioned; the continuity of the medial branch of the thoracodorsal nerve to the muscle was preserved when reconstruction was performed using the segmental latissimus dorsi flaps supplied by the main or lateral branch of the thoracodorsal artery. Results: From October 2010 to October 2019, 21 patients (on 24 sides) underwent reconstructive procedures for extensive scar contractures on the anterior chest. All flaps survived, and their donor sites were sutured directly. During a follow-up of 3 months to 8 years, the flaps became soft and exhibited color similar to that of the adjacent tissues. The limited neck and shoulder movements improved, and postoperatively, all female patients were satisfied with the shape of their breasts. Additionally, neither apparent weakening on the adduction, internal rotation, or extension strength of the shoulder joint on the affected side nor marked depression deformity in the back was observed. Conclusion: Pre-expanded muscle-sparing latissimus dorsi flaps with blood supply from the main or lateral branch of the thoracodorsal artery proved to be a desirable option for the reconstruction of extensive scar contractures on the anterior chest. | ||
| 650 | 4 | |a Latissimus dorsi flaps | |
| 650 | 4 | |a pre-expansion | |
| 650 | 4 | |a muscle-sparing | |
| 650 | 4 | |a thoracic scars | |
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| 700 | 0 | |a Shuchen GU |e verfasserin |4 aut | |
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| 700 | 0 | |a Tao ZAN |e verfasserin |4 aut | |
| 700 | 0 | |a Bin GU |e verfasserin |4 aut | |
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10.1016/S2096-6911(21)00014-5 doi (DE-627)DOAJ024868884 (DE-599)DOAJ93d03ca4335d4723acba2bfa8ecbdc73 DE-627 ger DE-627 rakwb eng RD1-811 Zhichao WANG verfasserin aut Pre-expanded Muscle-sparing Latissimus Dorsi Flaps for Reconstruction of Severe Scar Contractures on the Anterior Chest 2020 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier ABSTRACT: Objective: To investigate the utility of pre-expanded muscle-sparing latissimus dorsi flaps in the reconstruction of deformities secondary to severe scar contractures on the anterior chest. Methods: The function of the latissimus dorsi was preserved with blood supply from the main or lateral branch of the thoracodorsal artery. The entire treatment period was divided into two stages, during which segmental latissimus dorsi flaps were pre-expanded in stage I and anterior chest scar deformities were reconstructed in stage II.During stage I, the musculocutaneous perforators arising from the lateral branch of the thoracodorsal artery were determined by ultrasound preoperatively; the flap design included the anterior segment of the latissimus dorsi supplied by the musculocutaneous perforators from the lateral branch; and a tissue expander was placed following flap dissection and then infused with saline intermittently for 4–6 months.In stage II, the chest scars were excised, and breast tissues were repositioned; the continuity of the medial branch of the thoracodorsal nerve to the muscle was preserved when reconstruction was performed using the segmental latissimus dorsi flaps supplied by the main or lateral branch of the thoracodorsal artery. Results: From October 2010 to October 2019, 21 patients (on 24 sides) underwent reconstructive procedures for extensive scar contractures on the anterior chest. All flaps survived, and their donor sites were sutured directly. During a follow-up of 3 months to 8 years, the flaps became soft and exhibited color similar to that of the adjacent tissues. The limited neck and shoulder movements improved, and postoperatively, all female patients were satisfied with the shape of their breasts. Additionally, neither apparent weakening on the adduction, internal rotation, or extension strength of the shoulder joint on the affected side nor marked depression deformity in the back was observed. Conclusion: Pre-expanded muscle-sparing latissimus dorsi flaps with blood supply from the main or lateral branch of the thoracodorsal artery proved to be a desirable option for the reconstruction of extensive scar contractures on the anterior chest. Latissimus dorsi flaps pre-expansion muscle-sparing thoracic scars Surgery Dujuan LIU verfasserin aut Shuchen GU verfasserin aut Baoxiang TIAN verfasserin aut Tao ZAN verfasserin aut Bin GU verfasserin aut In Chinese Journal of Plastic and Reconstructive Surgery KeAi Communications Co. Ltd., 2022 2(2020), 2, Seite 6377-68 (DE-627)DOAJ07860026X 2772686X nnns volume:2 year:2020 number:2 pages:6377-68 https://doi.org/10.1016/S2096-6911(21)00014-5 kostenfrei https://doaj.org/article/93d03ca4335d4723acba2bfa8ecbdc73 kostenfrei http://www.sciencedirect.com/science/article/pii/S2096691121000145 kostenfrei https://doaj.org/toc/2096-6911 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ AR 2 2020 2 6377-68 |
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10.1016/S2096-6911(21)00014-5 doi (DE-627)DOAJ024868884 (DE-599)DOAJ93d03ca4335d4723acba2bfa8ecbdc73 DE-627 ger DE-627 rakwb eng RD1-811 Zhichao WANG verfasserin aut Pre-expanded Muscle-sparing Latissimus Dorsi Flaps for Reconstruction of Severe Scar Contractures on the Anterior Chest 2020 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier ABSTRACT: Objective: To investigate the utility of pre-expanded muscle-sparing latissimus dorsi flaps in the reconstruction of deformities secondary to severe scar contractures on the anterior chest. Methods: The function of the latissimus dorsi was preserved with blood supply from the main or lateral branch of the thoracodorsal artery. The entire treatment period was divided into two stages, during which segmental latissimus dorsi flaps were pre-expanded in stage I and anterior chest scar deformities were reconstructed in stage II.During stage I, the musculocutaneous perforators arising from the lateral branch of the thoracodorsal artery were determined by ultrasound preoperatively; the flap design included the anterior segment of the latissimus dorsi supplied by the musculocutaneous perforators from the lateral branch; and a tissue expander was placed following flap dissection and then infused with saline intermittently for 4–6 months.In stage II, the chest scars were excised, and breast tissues were repositioned; the continuity of the medial branch of the thoracodorsal nerve to the muscle was preserved when reconstruction was performed using the segmental latissimus dorsi flaps supplied by the main or lateral branch of the thoracodorsal artery. Results: From October 2010 to October 2019, 21 patients (on 24 sides) underwent reconstructive procedures for extensive scar contractures on the anterior chest. All flaps survived, and their donor sites were sutured directly. During a follow-up of 3 months to 8 years, the flaps became soft and exhibited color similar to that of the adjacent tissues. The limited neck and shoulder movements improved, and postoperatively, all female patients were satisfied with the shape of their breasts. Additionally, neither apparent weakening on the adduction, internal rotation, or extension strength of the shoulder joint on the affected side nor marked depression deformity in the back was observed. Conclusion: Pre-expanded muscle-sparing latissimus dorsi flaps with blood supply from the main or lateral branch of the thoracodorsal artery proved to be a desirable option for the reconstruction of extensive scar contractures on the anterior chest. Latissimus dorsi flaps pre-expansion muscle-sparing thoracic scars Surgery Dujuan LIU verfasserin aut Shuchen GU verfasserin aut Baoxiang TIAN verfasserin aut Tao ZAN verfasserin aut Bin GU verfasserin aut In Chinese Journal of Plastic and Reconstructive Surgery KeAi Communications Co. Ltd., 2022 2(2020), 2, Seite 6377-68 (DE-627)DOAJ07860026X 2772686X nnns volume:2 year:2020 number:2 pages:6377-68 https://doi.org/10.1016/S2096-6911(21)00014-5 kostenfrei https://doaj.org/article/93d03ca4335d4723acba2bfa8ecbdc73 kostenfrei http://www.sciencedirect.com/science/article/pii/S2096691121000145 kostenfrei https://doaj.org/toc/2096-6911 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ AR 2 2020 2 6377-68 |
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10.1016/S2096-6911(21)00014-5 doi (DE-627)DOAJ024868884 (DE-599)DOAJ93d03ca4335d4723acba2bfa8ecbdc73 DE-627 ger DE-627 rakwb eng RD1-811 Zhichao WANG verfasserin aut Pre-expanded Muscle-sparing Latissimus Dorsi Flaps for Reconstruction of Severe Scar Contractures on the Anterior Chest 2020 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier ABSTRACT: Objective: To investigate the utility of pre-expanded muscle-sparing latissimus dorsi flaps in the reconstruction of deformities secondary to severe scar contractures on the anterior chest. Methods: The function of the latissimus dorsi was preserved with blood supply from the main or lateral branch of the thoracodorsal artery. The entire treatment period was divided into two stages, during which segmental latissimus dorsi flaps were pre-expanded in stage I and anterior chest scar deformities were reconstructed in stage II.During stage I, the musculocutaneous perforators arising from the lateral branch of the thoracodorsal artery were determined by ultrasound preoperatively; the flap design included the anterior segment of the latissimus dorsi supplied by the musculocutaneous perforators from the lateral branch; and a tissue expander was placed following flap dissection and then infused with saline intermittently for 4–6 months.In stage II, the chest scars were excised, and breast tissues were repositioned; the continuity of the medial branch of the thoracodorsal nerve to the muscle was preserved when reconstruction was performed using the segmental latissimus dorsi flaps supplied by the main or lateral branch of the thoracodorsal artery. Results: From October 2010 to October 2019, 21 patients (on 24 sides) underwent reconstructive procedures for extensive scar contractures on the anterior chest. All flaps survived, and their donor sites were sutured directly. During a follow-up of 3 months to 8 years, the flaps became soft and exhibited color similar to that of the adjacent tissues. The limited neck and shoulder movements improved, and postoperatively, all female patients were satisfied with the shape of their breasts. Additionally, neither apparent weakening on the adduction, internal rotation, or extension strength of the shoulder joint on the affected side nor marked depression deformity in the back was observed. Conclusion: Pre-expanded muscle-sparing latissimus dorsi flaps with blood supply from the main or lateral branch of the thoracodorsal artery proved to be a desirable option for the reconstruction of extensive scar contractures on the anterior chest. Latissimus dorsi flaps pre-expansion muscle-sparing thoracic scars Surgery Dujuan LIU verfasserin aut Shuchen GU verfasserin aut Baoxiang TIAN verfasserin aut Tao ZAN verfasserin aut Bin GU verfasserin aut In Chinese Journal of Plastic and Reconstructive Surgery KeAi Communications Co. Ltd., 2022 2(2020), 2, Seite 6377-68 (DE-627)DOAJ07860026X 2772686X nnns volume:2 year:2020 number:2 pages:6377-68 https://doi.org/10.1016/S2096-6911(21)00014-5 kostenfrei https://doaj.org/article/93d03ca4335d4723acba2bfa8ecbdc73 kostenfrei http://www.sciencedirect.com/science/article/pii/S2096691121000145 kostenfrei https://doaj.org/toc/2096-6911 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ AR 2 2020 2 6377-68 |
| allfieldsGer |
10.1016/S2096-6911(21)00014-5 doi (DE-627)DOAJ024868884 (DE-599)DOAJ93d03ca4335d4723acba2bfa8ecbdc73 DE-627 ger DE-627 rakwb eng RD1-811 Zhichao WANG verfasserin aut Pre-expanded Muscle-sparing Latissimus Dorsi Flaps for Reconstruction of Severe Scar Contractures on the Anterior Chest 2020 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier ABSTRACT: Objective: To investigate the utility of pre-expanded muscle-sparing latissimus dorsi flaps in the reconstruction of deformities secondary to severe scar contractures on the anterior chest. Methods: The function of the latissimus dorsi was preserved with blood supply from the main or lateral branch of the thoracodorsal artery. The entire treatment period was divided into two stages, during which segmental latissimus dorsi flaps were pre-expanded in stage I and anterior chest scar deformities were reconstructed in stage II.During stage I, the musculocutaneous perforators arising from the lateral branch of the thoracodorsal artery were determined by ultrasound preoperatively; the flap design included the anterior segment of the latissimus dorsi supplied by the musculocutaneous perforators from the lateral branch; and a tissue expander was placed following flap dissection and then infused with saline intermittently for 4–6 months.In stage II, the chest scars were excised, and breast tissues were repositioned; the continuity of the medial branch of the thoracodorsal nerve to the muscle was preserved when reconstruction was performed using the segmental latissimus dorsi flaps supplied by the main or lateral branch of the thoracodorsal artery. Results: From October 2010 to October 2019, 21 patients (on 24 sides) underwent reconstructive procedures for extensive scar contractures on the anterior chest. All flaps survived, and their donor sites were sutured directly. During a follow-up of 3 months to 8 years, the flaps became soft and exhibited color similar to that of the adjacent tissues. The limited neck and shoulder movements improved, and postoperatively, all female patients were satisfied with the shape of their breasts. Additionally, neither apparent weakening on the adduction, internal rotation, or extension strength of the shoulder joint on the affected side nor marked depression deformity in the back was observed. Conclusion: Pre-expanded muscle-sparing latissimus dorsi flaps with blood supply from the main or lateral branch of the thoracodorsal artery proved to be a desirable option for the reconstruction of extensive scar contractures on the anterior chest. Latissimus dorsi flaps pre-expansion muscle-sparing thoracic scars Surgery Dujuan LIU verfasserin aut Shuchen GU verfasserin aut Baoxiang TIAN verfasserin aut Tao ZAN verfasserin aut Bin GU verfasserin aut In Chinese Journal of Plastic and Reconstructive Surgery KeAi Communications Co. Ltd., 2022 2(2020), 2, Seite 6377-68 (DE-627)DOAJ07860026X 2772686X nnns volume:2 year:2020 number:2 pages:6377-68 https://doi.org/10.1016/S2096-6911(21)00014-5 kostenfrei https://doaj.org/article/93d03ca4335d4723acba2bfa8ecbdc73 kostenfrei http://www.sciencedirect.com/science/article/pii/S2096691121000145 kostenfrei https://doaj.org/toc/2096-6911 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ AR 2 2020 2 6377-68 |
| allfieldsSound |
10.1016/S2096-6911(21)00014-5 doi (DE-627)DOAJ024868884 (DE-599)DOAJ93d03ca4335d4723acba2bfa8ecbdc73 DE-627 ger DE-627 rakwb eng RD1-811 Zhichao WANG verfasserin aut Pre-expanded Muscle-sparing Latissimus Dorsi Flaps for Reconstruction of Severe Scar Contractures on the Anterior Chest 2020 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier ABSTRACT: Objective: To investigate the utility of pre-expanded muscle-sparing latissimus dorsi flaps in the reconstruction of deformities secondary to severe scar contractures on the anterior chest. Methods: The function of the latissimus dorsi was preserved with blood supply from the main or lateral branch of the thoracodorsal artery. The entire treatment period was divided into two stages, during which segmental latissimus dorsi flaps were pre-expanded in stage I and anterior chest scar deformities were reconstructed in stage II.During stage I, the musculocutaneous perforators arising from the lateral branch of the thoracodorsal artery were determined by ultrasound preoperatively; the flap design included the anterior segment of the latissimus dorsi supplied by the musculocutaneous perforators from the lateral branch; and a tissue expander was placed following flap dissection and then infused with saline intermittently for 4–6 months.In stage II, the chest scars were excised, and breast tissues were repositioned; the continuity of the medial branch of the thoracodorsal nerve to the muscle was preserved when reconstruction was performed using the segmental latissimus dorsi flaps supplied by the main or lateral branch of the thoracodorsal artery. Results: From October 2010 to October 2019, 21 patients (on 24 sides) underwent reconstructive procedures for extensive scar contractures on the anterior chest. All flaps survived, and their donor sites were sutured directly. During a follow-up of 3 months to 8 years, the flaps became soft and exhibited color similar to that of the adjacent tissues. The limited neck and shoulder movements improved, and postoperatively, all female patients were satisfied with the shape of their breasts. Additionally, neither apparent weakening on the adduction, internal rotation, or extension strength of the shoulder joint on the affected side nor marked depression deformity in the back was observed. Conclusion: Pre-expanded muscle-sparing latissimus dorsi flaps with blood supply from the main or lateral branch of the thoracodorsal artery proved to be a desirable option for the reconstruction of extensive scar contractures on the anterior chest. Latissimus dorsi flaps pre-expansion muscle-sparing thoracic scars Surgery Dujuan LIU verfasserin aut Shuchen GU verfasserin aut Baoxiang TIAN verfasserin aut Tao ZAN verfasserin aut Bin GU verfasserin aut In Chinese Journal of Plastic and Reconstructive Surgery KeAi Communications Co. Ltd., 2022 2(2020), 2, Seite 6377-68 (DE-627)DOAJ07860026X 2772686X nnns volume:2 year:2020 number:2 pages:6377-68 https://doi.org/10.1016/S2096-6911(21)00014-5 kostenfrei https://doaj.org/article/93d03ca4335d4723acba2bfa8ecbdc73 kostenfrei http://www.sciencedirect.com/science/article/pii/S2096691121000145 kostenfrei https://doaj.org/toc/2096-6911 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ AR 2 2020 2 6377-68 |
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Methods: The function of the latissimus dorsi was preserved with blood supply from the main or lateral branch of the thoracodorsal artery. The entire treatment period was divided into two stages, during which segmental latissimus dorsi flaps were pre-expanded in stage I and anterior chest scar deformities were reconstructed in stage II.During stage I, the musculocutaneous perforators arising from the lateral branch of the thoracodorsal artery were determined by ultrasound preoperatively; the flap design included the anterior segment of the latissimus dorsi supplied by the musculocutaneous perforators from the lateral branch; and a tissue expander was placed following flap dissection and then infused with saline intermittently for 4–6 months.In stage II, the chest scars were excised, and breast tissues were repositioned; the continuity of the medial branch of the thoracodorsal nerve to the muscle was preserved when reconstruction was performed using the segmental latissimus dorsi flaps supplied by the main or lateral branch of the thoracodorsal artery. Results: From October 2010 to October 2019, 21 patients (on 24 sides) underwent reconstructive procedures for extensive scar contractures on the anterior chest. All flaps survived, and their donor sites were sutured directly. During a follow-up of 3 months to 8 years, the flaps became soft and exhibited color similar to that of the adjacent tissues. The limited neck and shoulder movements improved, and postoperatively, all female patients were satisfied with the shape of their breasts. Additionally, neither apparent weakening on the adduction, internal rotation, or extension strength of the shoulder joint on the affected side nor marked depression deformity in the back was observed. 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RD1-811 Pre-expanded Muscle-sparing Latissimus Dorsi Flaps for Reconstruction of Severe Scar Contractures on the Anterior Chest Latissimus dorsi flaps pre-expansion muscle-sparing thoracic scars |
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pre-expanded muscle-sparing latissimus dorsi flaps for reconstruction of severe scar contractures on the anterior chest |
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Pre-expanded Muscle-sparing Latissimus Dorsi Flaps for Reconstruction of Severe Scar Contractures on the Anterior Chest |
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ABSTRACT: Objective: To investigate the utility of pre-expanded muscle-sparing latissimus dorsi flaps in the reconstruction of deformities secondary to severe scar contractures on the anterior chest. Methods: The function of the latissimus dorsi was preserved with blood supply from the main or lateral branch of the thoracodorsal artery. The entire treatment period was divided into two stages, during which segmental latissimus dorsi flaps were pre-expanded in stage I and anterior chest scar deformities were reconstructed in stage II.During stage I, the musculocutaneous perforators arising from the lateral branch of the thoracodorsal artery were determined by ultrasound preoperatively; the flap design included the anterior segment of the latissimus dorsi supplied by the musculocutaneous perforators from the lateral branch; and a tissue expander was placed following flap dissection and then infused with saline intermittently for 4–6 months.In stage II, the chest scars were excised, and breast tissues were repositioned; the continuity of the medial branch of the thoracodorsal nerve to the muscle was preserved when reconstruction was performed using the segmental latissimus dorsi flaps supplied by the main or lateral branch of the thoracodorsal artery. Results: From October 2010 to October 2019, 21 patients (on 24 sides) underwent reconstructive procedures for extensive scar contractures on the anterior chest. All flaps survived, and their donor sites were sutured directly. During a follow-up of 3 months to 8 years, the flaps became soft and exhibited color similar to that of the adjacent tissues. The limited neck and shoulder movements improved, and postoperatively, all female patients were satisfied with the shape of their breasts. Additionally, neither apparent weakening on the adduction, internal rotation, or extension strength of the shoulder joint on the affected side nor marked depression deformity in the back was observed. Conclusion: Pre-expanded muscle-sparing latissimus dorsi flaps with blood supply from the main or lateral branch of the thoracodorsal artery proved to be a desirable option for the reconstruction of extensive scar contractures on the anterior chest. |
| abstractGer |
ABSTRACT: Objective: To investigate the utility of pre-expanded muscle-sparing latissimus dorsi flaps in the reconstruction of deformities secondary to severe scar contractures on the anterior chest. Methods: The function of the latissimus dorsi was preserved with blood supply from the main or lateral branch of the thoracodorsal artery. The entire treatment period was divided into two stages, during which segmental latissimus dorsi flaps were pre-expanded in stage I and anterior chest scar deformities were reconstructed in stage II.During stage I, the musculocutaneous perforators arising from the lateral branch of the thoracodorsal artery were determined by ultrasound preoperatively; the flap design included the anterior segment of the latissimus dorsi supplied by the musculocutaneous perforators from the lateral branch; and a tissue expander was placed following flap dissection and then infused with saline intermittently for 4–6 months.In stage II, the chest scars were excised, and breast tissues were repositioned; the continuity of the medial branch of the thoracodorsal nerve to the muscle was preserved when reconstruction was performed using the segmental latissimus dorsi flaps supplied by the main or lateral branch of the thoracodorsal artery. Results: From October 2010 to October 2019, 21 patients (on 24 sides) underwent reconstructive procedures for extensive scar contractures on the anterior chest. All flaps survived, and their donor sites were sutured directly. During a follow-up of 3 months to 8 years, the flaps became soft and exhibited color similar to that of the adjacent tissues. The limited neck and shoulder movements improved, and postoperatively, all female patients were satisfied with the shape of their breasts. Additionally, neither apparent weakening on the adduction, internal rotation, or extension strength of the shoulder joint on the affected side nor marked depression deformity in the back was observed. Conclusion: Pre-expanded muscle-sparing latissimus dorsi flaps with blood supply from the main or lateral branch of the thoracodorsal artery proved to be a desirable option for the reconstruction of extensive scar contractures on the anterior chest. |
| abstract_unstemmed |
ABSTRACT: Objective: To investigate the utility of pre-expanded muscle-sparing latissimus dorsi flaps in the reconstruction of deformities secondary to severe scar contractures on the anterior chest. Methods: The function of the latissimus dorsi was preserved with blood supply from the main or lateral branch of the thoracodorsal artery. The entire treatment period was divided into two stages, during which segmental latissimus dorsi flaps were pre-expanded in stage I and anterior chest scar deformities were reconstructed in stage II.During stage I, the musculocutaneous perforators arising from the lateral branch of the thoracodorsal artery were determined by ultrasound preoperatively; the flap design included the anterior segment of the latissimus dorsi supplied by the musculocutaneous perforators from the lateral branch; and a tissue expander was placed following flap dissection and then infused with saline intermittently for 4–6 months.In stage II, the chest scars were excised, and breast tissues were repositioned; the continuity of the medial branch of the thoracodorsal nerve to the muscle was preserved when reconstruction was performed using the segmental latissimus dorsi flaps supplied by the main or lateral branch of the thoracodorsal artery. Results: From October 2010 to October 2019, 21 patients (on 24 sides) underwent reconstructive procedures for extensive scar contractures on the anterior chest. All flaps survived, and their donor sites were sutured directly. During a follow-up of 3 months to 8 years, the flaps became soft and exhibited color similar to that of the adjacent tissues. The limited neck and shoulder movements improved, and postoperatively, all female patients were satisfied with the shape of their breasts. Additionally, neither apparent weakening on the adduction, internal rotation, or extension strength of the shoulder joint on the affected side nor marked depression deformity in the back was observed. Conclusion: Pre-expanded muscle-sparing latissimus dorsi flaps with blood supply from the main or lateral branch of the thoracodorsal artery proved to be a desirable option for the reconstruction of extensive scar contractures on the anterior chest. |
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