The Axillary Approach to Raising the Latissimus Dorsi Free Flap for Facial Re-Animation: A Descriptive Surgical Technique

The latissimus dorsi flap is popular due to the versatile nature of its applications. When used as a pedicled flap it provides a robust solution when soft tissue coverage is required following breast, thoracic and head and neck surgery. Its utilization as a free flap is extensive due to the muscle&#...

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Main Authors: Jonathan Leckenby, Daniel Butler, Adriaan Grobbelaar
Format: Article
Language:English
Published: Thieme Medical Publishers, Inc. 2015-01-01
Series:Archives of Plastic Surgery
Subjects:
Online Access:http://www.thieme-connect.de/DOI/DOI?10.5999/aps.2015.42.1.73
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author Jonathan Leckenby
Daniel Butler
Adriaan Grobbelaar
author_facet Jonathan Leckenby
Daniel Butler
Adriaan Grobbelaar
author_sort Jonathan Leckenby
collection DOAJ
description The latissimus dorsi flap is popular due to the versatile nature of its applications. When used as a pedicled flap it provides a robust solution when soft tissue coverage is required following breast, thoracic and head and neck surgery. Its utilization as a free flap is extensive due to the muscle's size, constant anatomy, large caliber of the pedicle and the fact it can be used for functional muscle transfers. In facial palsy it provides the surgeon with a long neurovascular pedicle that is invaluable in situations where commonly used facial vessels are not available, in congenital cases or where previous free functional muscle transfers have been attempted, or patients where a one-stage procedure is indicated and a long nerve is required to reach the contra-lateral side. Although some facial palsy surgeons use the trans-axillary approach, an operative guide of raising the flap by this method has not been provided. A clear guide of raising the flap with the patient in the supine position is described in detail and offers the benefits of reducing the risk of potential brachial plexus injury and allows two surgical teams to work synchronously to reduce operative time.
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spelling doaj.art-e24c510fdb8f4d8bb7eb9dea8186c20f2022-12-22T04:02:01ZengThieme Medical Publishers, Inc.Archives of Plastic Surgery2234-61632234-61712015-01-014201737710.5999/aps.2015.42.1.73600The Axillary Approach to Raising the Latissimus Dorsi Free Flap for Facial Re-Animation: A Descriptive Surgical TechniqueJonathan Leckenby0Daniel Butler1Adriaan Grobbelaar2Department of Plastic and Reconstructive Surgery, The Royal Free Hospital, London, UKDepartment of Plastic and Reconstructive Surgery, The Royal Free Hospital, London, UKDepartment of Plastic and Reconstructive Surgery, The Royal Free Hospital, London, UKThe latissimus dorsi flap is popular due to the versatile nature of its applications. When used as a pedicled flap it provides a robust solution when soft tissue coverage is required following breast, thoracic and head and neck surgery. Its utilization as a free flap is extensive due to the muscle's size, constant anatomy, large caliber of the pedicle and the fact it can be used for functional muscle transfers. In facial palsy it provides the surgeon with a long neurovascular pedicle that is invaluable in situations where commonly used facial vessels are not available, in congenital cases or where previous free functional muscle transfers have been attempted, or patients where a one-stage procedure is indicated and a long nerve is required to reach the contra-lateral side. Although some facial palsy surgeons use the trans-axillary approach, an operative guide of raising the flap by this method has not been provided. A clear guide of raising the flap with the patient in the supine position is described in detail and offers the benefits of reducing the risk of potential brachial plexus injury and allows two surgical teams to work synchronously to reduce operative time.http://www.thieme-connect.de/DOI/DOI?10.5999/aps.2015.42.1.73facial palsyfacial reanimationfree flaplatissimus dorsi
spellingShingle Jonathan Leckenby
Daniel Butler
Adriaan Grobbelaar
The Axillary Approach to Raising the Latissimus Dorsi Free Flap for Facial Re-Animation: A Descriptive Surgical Technique
Archives of Plastic Surgery
facial palsy
facial reanimation
free flap
latissimus dorsi
title The Axillary Approach to Raising the Latissimus Dorsi Free Flap for Facial Re-Animation: A Descriptive Surgical Technique
title_full The Axillary Approach to Raising the Latissimus Dorsi Free Flap for Facial Re-Animation: A Descriptive Surgical Technique
title_fullStr The Axillary Approach to Raising the Latissimus Dorsi Free Flap for Facial Re-Animation: A Descriptive Surgical Technique
title_full_unstemmed The Axillary Approach to Raising the Latissimus Dorsi Free Flap for Facial Re-Animation: A Descriptive Surgical Technique
title_short The Axillary Approach to Raising the Latissimus Dorsi Free Flap for Facial Re-Animation: A Descriptive Surgical Technique
title_sort axillary approach to raising the latissimus dorsi free flap for facial re animation a descriptive surgical technique
topic facial palsy
facial reanimation
free flap
latissimus dorsi
url http://www.thieme-connect.de/DOI/DOI?10.5999/aps.2015.42.1.73
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