APPLICATION OF PEDICLED LATISSIMUS DORSI KISS FLAP TO REPAIR CHEST WALL SKIN DEFECTS AFTER TUMOR RESECTION_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

 LüChunliu ¹ ,  LIZan ¹ , ZHOUXiao ² , SONGDajiang ¹ , PENGXiaowei ¹ , ZHOUBo ¹ , YANGLichang ¹

1. Department of Breast Oncoplastic Surgery, Hunan Cancer Hospital & the Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha Hunan, 410013, P. R. China;
2. Department of Oncoplastic Surgery, Hunan Cancer Hospital & the Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha Hunan, 410013, P. R. China;

Corresponding?author：

LüChunliu, Email: lvchunliu@hnszlyy.com; LIZan, Email: lizan@hnszlyy.com

Keywords：

Kiss flap; Latissimus dorsi muscle flap; Chest; Skin and soft tissue defect; Wound repair

DOI：

10.7507/1002-1892.20160310

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective To investigate the clinical value of pedicled latissimus dorsi Kiss flap in repairing chest wall large skin defect after tumor operation. Methods A retrospective analysis was made on the clinical data from 15 cases of chest wall tumors treated between December 2010 and December 2015. There were 2 males and 13 females with an average age of 51.8 years (range, 43-60 years); there were 11 cases of locally advanced breast cancer, 3 cases of fibrosarcoma in chest wall, and 1 case of chest wall radiation ulcer with a median disease duration of 24.1 months (range, 6 months to 8 years). The area of skin defects was 17 cm×12 cm to 20 cm×18 cm after primary tumor resection; the pedicled latissimus dorsi Kiss flap was designed to repair wounds. The flap was a two-lobed flap at a certain angle on the surface of latissimus dorsi based on the thoracodorsal artery, with a size of 17 cm×6 cm to 20 cm×9 cm for each lobe. The donor site was sutured directly. Results Fourteen flaps survived with primary healing of wound; delayed healing was observed in 1 flap because of distal necrosis; and healing by first intention was obtained at the donor sites. The follow-up time was from 6 months to 3 years (mean, 21.6 months). The flap had good appearance with no bloated pedicle. The shoulder joint activities were normal. No local recurrence occurred, but distant metastasis in 2 cases. No obvious scar was found at donor sites. Conclusion The application of pedicled latissimus dorsi Kiss flap to repair chest wall skin defects after tumor resection has important clinical value, because of the advatages of simple operation, minor donor site damage and rapid postoperative recovery, especially for late stage cancer patients.

Citation： LüChunliu, LIZan, ZHOUXiao, SONGDajiang, PENGXiaowei, ZHOUBo, YANGLichang. APPLICATION OF PEDICLED LATISSIMUS DORSI KISS FLAP TO REPAIR CHEST WALL SKIN DEFECTS AFTER TUMOR RESECTION. Chinese Journal of Reparative and Reconstructive Surgery, 2016, 30(12): 1498-1501. doi: 10.7507/1002-1892.20160310 Copy

1.	Baudet J, Guimberteau JC, Nascimento E. Successful clinical tranfer of two free thoracodorsal axillary flaps. Plast Reconstr Surg, 1976, 58(6):680-688.
2.	王進, 耿中利, 馬斌林.乳腺癌術后帶蒂背闊肌皮瓣部分聯合假體植入一期乳房再造.中國修復重建外科雜志, 2012, 26(7):885-886.
3.	張毅, 曾瑞曦, 嚴鳳嬌, 等.乳腺癌根治術后二期島狀背闊肌肌皮瓣的乳房再造及腋前皺襞重建.中國修復重建外科雜志, 2009, 23(3):379-380.
4.	郭伶俐, 邢新, 李軍輝, 等.胸壁全層缺損的修復重建.中國修復重建外科雜志, 2011, 25(12):1465-1468.
5.	劉建書, 唐舉玉, 劉鳴江, 等.背闊肌皮瓣修復四肢軟組織缺損的臨床應用.吉林醫學, 2010, 31(9):1160-1161.
6.	Zhang YX, Hayakawa TJ, Levin LS, et al. The Economy in Autologous Tissue Transfer:Part 1. The Kiss Flap Technique. Plast Reconstr Surg, 2016, 137(3):1018-1030.
7.	Zhang YX, Xi W, Lazzeri D, et al. Bipaddle radial forearm flap for head and neck reconstruction. J Craniofac Surg, 2015, 26(2):350-353.
8.	Marsh DJ, Chana JS. Reconstruction of very large defects:a novel application of the double skin paddle anterolateral thigh flap design provides for primary donor-site closure. J Plast Reconstr Aesthet Surg, 2010, 63(1):120-125.
9.	Zhang YX, Messmer C, Pang FK, et al. A novel design of the multilobed latissimus dorsi myocutaneous flap to achieve primary donor-site closure in the reconstruction of large defects. Plast Reconstr Surg, 2013, 131(5):752e-758e.
10.	Tobin GR, Schusterman M, Peterson GH, et al. The intramuscular neurovascular anatomy of the latissimus dorsi muscle:the basis for splitting the flap. Plast Reconstr Surg, 1981, 67(5):637-641.
11.	顧建英, 亓發芝, 徐劍煒, 等.擴大背闊肌肌皮瓣乳房再造術后供區并發癥的探討.中華整形外科雜志, 2005, 21(5):325-327.

1. Baudet J, Guimberteau JC, Nascimento E. Successful clinical tranfer of two free thoracodorsal axillary flaps. Plast Reconstr Surg, 1976, 58(6):680-688.
2. 王進, 耿中利, 馬斌林.乳腺癌術后帶蒂背闊肌皮瓣部分聯合假體植入一期乳房再造.中國修復重建外科雜志, 2012, 26(7):885-886.
3. 張毅, 曾瑞曦, 嚴鳳嬌, 等.乳腺癌根治術后二期島狀背闊肌肌皮瓣的乳房再造及腋前皺襞重建.中國修復重建外科雜志, 2009, 23(3):379-380.
4. 郭伶俐, 邢新, 李軍輝, 等.胸壁全層缺損的修復重建.中國修復重建外科雜志, 2011, 25(12):1465-1468.
5. 劉建書, 唐舉玉, 劉鳴江, 等.背闊肌皮瓣修復四肢軟組織缺損的臨床應用.吉林醫學, 2010, 31(9):1160-1161.
6. Zhang YX, Hayakawa TJ, Levin LS, et al. The Economy in Autologous Tissue Transfer:Part 1. The Kiss Flap Technique. Plast Reconstr Surg, 2016, 137(3):1018-1030.
7. Zhang YX, Xi W, Lazzeri D, et al. Bipaddle radial forearm flap for head and neck reconstruction. J Craniofac Surg, 2015, 26(2):350-353.
8. Marsh DJ, Chana JS. Reconstruction of very large defects:a novel application of the double skin paddle anterolateral thigh flap design provides for primary donor-site closure. J Plast Reconstr Aesthet Surg, 2010, 63(1):120-125.
9. Zhang YX, Messmer C, Pang FK, et al. A novel design of the multilobed latissimus dorsi myocutaneous flap to achieve primary donor-site closure in the reconstruction of large defects. Plast Reconstr Surg, 2013, 131(5):752e-758e.
10. Tobin GR, Schusterman M, Peterson GH, et al. The intramuscular neurovascular anatomy of the latissimus dorsi muscle:the basis for splitting the flap. Plast Reconstr Surg, 1981, 67(5):637-641.
11. 顧建英, 亓發芝, 徐劍煒, 等.擴大背闊肌肌皮瓣乳房再造術后供區并發癥的探討.中華整形外科雜志, 2005, 21(5):325-327.

Chinese Journal of Reparative and Reconstructive Surgery

APPLICATION OF PEDICLED LATISSIMUS DORSI KISS FLAP TO REPAIR CHEST WALL SKIN DEFECTS AFTER TUMOR RESECTION

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