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Anatomical basis of latissimus dorsi myocutaneous flap: clinical applications

Bases anatomiques du lambeau myocutané du m. grand dorsal; applications cliniques

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Summary

The anatomical study was carried out using 40 preserved cadaveric specimens of latissimus dorsi myocutaneous flaps. It included dissections, angiographies and tissue clearing after arterial injection with latex. The results proved that the dominant vascular supply, the thoracodorsal a., has an almost constant pattern of intramuscular distribution. In addition, there are two sets of segmental pedicles, from the intercostal and lumbar vessels, supplying the medial third of the muscle. The accurate localization of the intramuscular distribution of the thoracodorsal a. permitted the proper design of several island flaps with competent vascularity. The designed flaps were successfully applied in 10 cases for reconstruction of breast, axilla, neck and chest wall.

Résumé

Cette étude anatomique a été réalisée sur 40 cadavres conservés. Elle a comporté des dissections et des angiographies après injections artérielles de latex. Les résultats ont montré que la vascularisation dominante était assurée par l'a. thoraco-dorsale qui a un schéma de distribution constant à l'intérieur du muscle. De plus, il existe 2 autres types de pédicules segmentaires qui proviennent des vaisseaux intercostaux et lombaires et qui vascularisent le tiers interne du muscle. La localisation précise de la distribution intramusculaire de l'a. thoraco-dorsale permet d'envisager plusieurs lambeaux en îlot avec une vascularisation fiable. Les lambeaux ainsi désignés ont été réalisés avec succès dans 10 cas de reconstruction du sein, de la paroi thoracique, de la fosse axilaire et du cou.

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Authors and Affiliations

  1. Department of Anatomy, Faculty of Medicine, Alexandria University, Egypt

    S. H. El-Maasarany & E. Sharaf

  2. Department of Plastic Surgery Unit, Faculty of Medicine, Alexandria University, Egypt

    F. Moustafa, A. Borhan, A. Abdel-Fattah & A. Hamza

Authors
  1. S. H. El-Maasarany
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  2. E. Sharaf
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  3. F. Moustafa
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  4. A. Borhan
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  5. A. Abdel-Fattah
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  6. A. Hamza
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El-Maasarany, S.H., Sharaf, E., Moustafa, F. et al. Anatomical basis of latissimus dorsi myocutaneous flap: clinical applications. Surg Radiol Anat 11, 197–203 (1989). https://doi.org/10.1007/BF02337821

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  • DOI: https://doi.org/10.1007/BF02337821

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