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.	王进, 耿中利, 马斌林.乳腺癌术后带蒂背阔肌皮瓣部分联合假体植入一期乳房再造.中国修复重建外科杂志, 2012, 26(7):885-886.
3.	张毅, 曾瑞曦, 严凤娇, 等.乳腺癌根治术后二期岛状背阔肌肌皮瓣的乳房再造及腋前皱襞重建.中国修复重建外科杂志, 2009, 23(3):379-380.
4.	郭伶俐, 邢新, 李军辉, 等.胸壁全层缺损的修复重建.中国修复重建外科杂志, 2011, 25(12):1465-1468.
5.	刘建书, 唐举玉, 刘鸣江, 等.背阔肌皮瓣修复四肢软组织缺损的临床应用.吉林医学, 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.	顾建英, 亓发芝, 徐剑炜, 等.扩大背阔肌肌皮瓣乳房再造术后供区并发症的探讨.中华整形外科杂志, 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. 王进, 耿中利, 马斌林.乳腺癌术后带蒂背阔肌皮瓣部分联合假体植入一期乳房再造.中国修复重建外科杂志, 2012, 26(7):885-886.
3. 张毅, 曾瑞曦, 严凤娇, 等.乳腺癌根治术后二期岛状背阔肌肌皮瓣的乳房再造及腋前皱襞重建.中国修复重建外科杂志, 2009, 23(3):379-380.
4. 郭伶俐, 邢新, 李军辉, 等.胸壁全层缺损的修复重建.中国修复重建外科杂志, 2011, 25(12):1465-1468.
5. 刘建书, 唐举玉, 刘鸣江, 等.背阔肌皮瓣修复四肢软组织缺损的临床应用.吉林医学, 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. 顾建英, 亓发芝, 徐剑炜, 等.扩大背阔肌肌皮瓣乳房再造术后供区并发症的探讨.中华整形外科杂志, 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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