The "reversed" latissimus dorsi muscle flap with conditioning delay for closure of a lower thoracic tuberculous empyema.

The patient was a 57-year-old male with a tuberculous empyema of the right lower thorax which penetrated the chest wall. One week before operation, the thoracodorsal vessels, which are the dominant blood supply of the latissimus dorsi (LD) muscle, were divided to encourage adaptation of the secondary blood supply of the flap. Then the "reversed" LD muscle flap, pedicled at the lower posterior side, was transposed into the empyema cavity. The postoperative course was satisfactory, and the patient is now in good health without recurrence 12 months after the operation. The "reversed" LD muscle flap with conditioning delay before surgery is useful for lower thoracic empyema.