Achieving Glamorous Natural & Youthful Skin & Restoring Normality....
Natural Rejuvenation Clinics - The New Pacific International Hospital in Port Moresby & the New Lae International Hospital in Lae, Papua New Guinea, by Dr. William Nimle Mol (MBBS, PhD).
-Plastic, Reconstructive, Aesthetic/Cosmetic & Dermatologic Surgeon
-Vascular Anomalies (Birth Marks) Specialist
Friday, 19 September 2014
Latissimus Dorsi Muscle Flap for Reconstruction
Latissimus Dorsi Muscle is the largest muscle in the body. It
is located towards the lateral torso & the back. It functions to
adduct the arm or cause the arm to move towards the center of
the body & internally rotate it or cause the arm to rotate
large myocutaneous (muscle & skin) flap (an
isolated/mobilized piece of muscle & skin with the blood supply
intact) may be elevated & harvested on a single pedicle
(main artery & vein to that piece of muscle & skin). In this case the Subscapular Artery.
Step 1: After incising over the skin marking down to the muscle
sheet (covering), undermine the skin medially, starting from the
medial side of the skin marking & over the Latissimus Dorsi (LD) muscle sheet (covering), until the medial (towards the body center)
border of the muscle is seen.
Step 2: Elevate the Latissimus Dorsi muscle from the medial border, going under
the muscle. Undermine & free the muscle up until the mid-line of
the muscle & slightly beyond
Step 4: Undermine the skin laterally starting from the lateral
margins of the skin design & over the muscle sheet for about 3-4
cm beyond. Then divide the muscle about 2-3 cm from the skin marking
(incised border), starting from the medial (central side), caudal
(lower side), lateral (outer side) then cephalically (towards the
Step 5: Once all the muscle origin is freed, elevate the muscle &
again confirm the pedicle, especially the demarcation or separation
of the pedicle & the muscle insertion. Insert a large artery
forceps here, making sure not to include the pedicle in it. Then
divide the portion of muscle overt it, using a diathermy.
After this step, the flap will only be supported by the pedicle &
loose connective tissues around it. Care must be taken not to apply
too much tension to it. However, the loose connective tissues may be
carefully freed, up to the junction of the axillary artery to free
the pedicle further.
Step 6: Donor site closure
Step 7: Recipient site preparation & flap application
followed by closure
A Case of Post Maxillary Cancer Ablation; Defect Reconstruction: