Subscribe to RSS
DOI: 10.1055/s-2004-836123
Advantages of Using Intercostal Vessels as the Recipients for Free Flaps Covering Lumbar Defects
Publication History
Publication Date:
09 November 2004 (online)
Anatomic conditions in the lumbar region can complicate procedures for covering defects. In particular, a free flap is often required when the defect is large, in which case suitable recipient vessels must be found to insure revascularization. This report concerns a 50-year-old woman with multiple basal-cell carcinomas in the lumbar radiodermatitis zone, who underwent a large resection from D10 to S2. The defect was repaired using a free latissimus dorsi flap revascularized by microvascular anastomosis to the 8th intercostal pedicle. The advantages of using these recipient vessels are then considered relative to reports in the literature.
KEYWORDS
Lumbar defect - free flap - intercostal pedicle
REFERENCES
- 1 Lantieri L A, Tantaoui B, Rimarex F A et al.. Lower back coverage with endoscopically harvested pedicled greater omental flap. Plast Reconstr Surg. 1999; 103 960-963
- 2 Kroll S S, Rosenfield L. Perforator-based flaps for low posterior midline defects. Plast Reconstr Surg. 1988; 81 561-566
- 3 Koshima I, Moriguchi T, Soeda S et al.. The gluteal perforator-based flap for repair of sacral pressure sores. Plast Reconstr Surg. 1993; 91 678-683
- 4 Yanai A, Bandoh Y, Tsuzuki K. Bilateral gluteal thigh flaps for closure of large defects in the lumbo-sacral region and perineal region. Plast Reconstr Surg. 1991; 88 703-706
- 5 Komuro Y, Takato T, Ueda K, Harii K. Experience with U-shaped gluteal thigh flap for reconstruction of radionecrosis in the sacral region. Ann Plast Surg. 1993; 31 475-478
- 6 Salibian A H, Tesoro V R, Wood D L. Case report: staged transfer of a free microvascular latissimus dorsi myocutaneous flap using saphenous vein grafts. Plast Reconstr Surg. 1983; 71 543-547
- 7 Nahai F, Hagerty R. Case report: one-stage microvascular transfer of a latissimus flap to the sacrum using vein grafts. Plast Reconstr Surg. 1986; 77 312-315
- 8 Rostane D, Manise O, Lucas A et al.. Latissimus free flap revascularized with vein graft on femoral vessels [in French]. Ann Chir Plast Esthet. 1993; 38 331-336
- 9 Di Benedetto G, Bertani A, Pallua N. The free latissimus dorsi flap revisited: a primary option for coverage of wide recurrent lumbosacral defects. Plast Reconstr Surg. 2002; 109 1960-1965
- 10 Yamamoto Y, Nohira K, Shintomi Y, Igawa H, Ohura T. Reconstruction of recurrent pressure sores using free flaps. J Reconstr Microsurg. 1992; 8 433-436
- 11 Daniel R K, Kerrigan C L, Gard D A. The great potential of the intercostal flap for torso reconstruction. Plast Reconstr Surg. 1978; 61 653-665
- 12 Park S, Koh K S. Superior gluteal vessel as recipient for free flap reconstruction of lumbosacral defect. Plast Reconstr Surg. 1998; 101 1842-1849
- 13 Park S. Muscle-splitting approach to superior and inferior gluteal vessels: versatile source of recipient vessels for free-tissue transfer to sacral, gluteal, and ischial regions. Plast Reconstr Surg. 2000; 106 81-86
- 14 Ogawa R, Hyakusoka H, Murakami M, Aoki R, Tanuma K, Pennington D G. An anatomical and clinical study of the dorsal intercostals cutaneous perforators, and application to free microvascular augmented subdural vascular network. Br J Plast Surg. 2002; 55 396-401
- 15 Tutor E G, Auba C, Benito C, Rabago G, Kreutler V. Easy venous superdrainage in DIEP flap breast reconstruction through the intercostal branch. J Reconstr Microsurg. 2002; 18 595-598
Franck DuteilleM.D.
Service de chirurgie plastique reconstructrice et esthétique
CHU, Hôpital Jean Monnet
44093 Nantes cedex 01, France