Novel Split Latissimus Dorsi Fasciocutaneous Flap With Vascularized Lymph Node Transfer.

Abstract

In this retrospective case report, we evaluate the successful application of the split latissimus dorsi flap (s-LDF) paired with vascularized lymph node transfer (VLNT), using postoncological resection in the setting of lower extremity lymphedema. In this case report, we describe a 72-year-old man with recurrent lower extremity melanoma and iatrogenic lymphedema who underwent s-LDF with integration of VLNT. We highlight incorporating VLNT with s-LDF in a 1-stage execution to address both the soft tissue defect and lymphedema. Furthermore, the intrinsic design of the split technique ensures the preservation of the latissimus dorsi's functional integrity while reducing donor site morbidity. This report highlights the adaptability and clinical efficacy of the s-LDF, advocating for its incorporation in complex oncological excisions, particularly in lower extremity reconstructions with significant soft tissue defects. Further studies are warranted to validate the reproducibility and long-term efficacy of the s-LDF with VLNT.