Division of Plastic and Reconstructive Surgery, National Cancer Center Hospital, Tokyo, Japan.
Microsurgery. 2014 Jan;34(1):20-2. doi: 10.1002/micr.22108. Epub 2013 Jul 9.
Closing large skin defects of the upper back is a challenging problem. We have developed an efficient design for a latissimus dorsi musculocutaneous flap for reconstruction in this region. The longitudinal axis of the skin island was designed to be perpendicular to the line of least skin tension at the recipient site so that primary closure of the flap donor site changed the shape of the recipient site to one that was easier to close. We used this method for four patients with skin cancers or soft-tissue sarcomas of the upper back in 2011 and 2012. The size of skin defects after wide excision ranged from 11 × 10 to 25 × 20 cm(2) , and all skin defects could be covered by the flaps and all wounds of donor site could be closed without skin grafts. No wound complications occurred in any patient. Functional and aesthetic outcomes were satisfactory in all patients. This flap design is effective for reconstructing large skin defects of the upper back.
修复上背部的大面积皮肤缺损是一个具有挑战性的问题。我们设计了一种高效的背阔肌肌皮瓣用于该区域的重建。皮岛的纵轴设计为垂直于受区的最小皮肤张力线，以便皮瓣供区的直接缝合改变受区的形状，使其更容易闭合。我们在 2011 年和 2012 年使用该方法治疗了 4 例上背部皮肤癌或软组织肉瘤患者。广泛切除后的皮肤缺损大小为 11×10 至 25×20cm2，所有皮瓣均可覆盖所有供区创面，无需植皮即可闭合。所有患者均未发生伤口并发症。所有患者的功能和美学效果均满意。这种皮瓣设计对于修复上背部的大面积皮肤缺损是有效的。
