Feng Allen L, Nasser Hassan B, Rosko Andrew J, Casper Keith A, Malloy Kelly M, Stucken Chaz L, Prince Mark E, Chinn Steven B, Spector Matthew E
Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Ann Arbor, MI 48109, USA.
Plast Aesthet Res. 2021;8. doi: 10.20517/2347-9264.2021.03. Epub 2021 Feb 25.
Free tissue transfer has become the gold standard for reconstruction within the head and neck. However, there are still many instances where pedicled locoregional flaps are the optimal reconstructive option. When myofascial tissue is needed, several options have been described throughout the literature. Various trapezius flaps have been used, although these have variable vascular anatomy and significant donor site morbidity. The pectoralis major myofascial flap has become a mainstay in head and neck reconstruction for its ease of harvest and reliability but suffers from similar issues with donor site morbidity. The pedicled latissimus dorsi flap (PLDF) is another reliable option that has been used for multiple different ablative sites within the head and neck. The thin, pliable structure of the latissimus dorsi makes it a viable option for many defects, and recent reports also support its feasibility for use in an interdisciplinary two-team approach. Furthermore, the donor site morbidity of the PLDF is minimal compared to other similar myofascial options. In this article, we describe the surgical considerations and operative techniques for PLDF transfer along with a review of its associated donor site morbidity.
游离组织移植已成为头颈部重建的金标准。然而，在许多情况下，带蒂局部皮瓣仍是最佳的重建选择。当需要肌筋膜组织时，文献中已描述了多种选择。尽管各种斜方肌皮瓣的血管解剖结构各不相同且供区并发症严重，但仍被使用。胸大肌肌筋膜皮瓣因其易于切取和可靠性，已成为头颈部重建的主要手段，但也存在类似的供区并发症问题。带蒂背阔肌皮瓣（PLDF）是另一种可靠的选择，已用于头颈部多个不同的切除部位。背阔肌薄而柔韧的结构使其成为许多缺损的可行选择，最近的报告也支持其在跨学科双团队方法中的可行性。此外，与其他类似的肌筋膜选择相比，PLDF的供区并发症最小。在本文中，我们描述了PLDF转移的手术注意事项和手术技术，并对其相关的供区并发症进行了综述。
