Reverse turnover pedicled latissimus dorsi muscle flap for lower back reconstruction: Two case reports

Rationale: Large soft tissue defects on the lower back represent a treatment challenge. Among a variety of reconstructive procedures, the latissimus dorsi (LD) muscle or musculocutaneous flap is one of most frequently used pedicled flaps. However, the pedicled LD flap carries a bulky pivot point and a short arc of rotation. If a pedicled LD muscle flap is transferred using a reverse turnover pattern, theses drawbacks can be avoided. Patient concerns: The first patient was a 56-year-old man with hepatocellular carcinoma and multiple bone metastases involving D11-L4 vertebral bodies. A chronic ulcer was developed on his lower back area after palliative radiation therapy for bone metastases. The second patient was a 41-year-old man with a soft tissue mass on his lower back, which was diagnosed as dermatofibrosarcoma protuberans via previous incisional biopsy. A large soft tissue defect was developed on his lower back as a result of a wide resection. Diagnosis: Both patients were referred to our department for the treatment of a large soft tissue defect on lower back. Interventions: They underwent the reverse turnover pedicled LD muscle flap and split-thickness skin graft. Outcomes: At postoperative 6-month follow-up, both patients remained free of wound problem. Lessons: The reverse turnover pedicled LD muscle flap is quite straightforward. Even if a soft tissue defect in the lower back is large or complicated by infection or radiation therapy, perfusion of LD b...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research