[Repair of soft tissue defects in lower extremities by latissimus dorsi myocutaneous flap with T type of vascular pedicle].

Objective: To investigate the Application of latissimus dorsi myocutaneous flap with T type of vascular pedicle in repairing soft tissue defects at lower extremities.

Methods: Between January 2003 and August 2013,16 patients with skin and soft tissue defects at lower extremities were treated with T type vascular pedicled latissimus dorsi myocutaneous flap through bridge transplantation. There were 13 male and 3 female patients with an average age of 36.2 years(range,17-54 years).Skin and soft tissue defects in the lower extremities ranged from 18 cm × 13 cm to 32 cm × 15 cm. The T-configuration vascular anastomosis was formed by anastomosing the subscapular and circumflex scapular vessels to the proximal and distal ends of the posterior tibial vessel broken in the normal leg respectively in an end-to-end manner. The latissimus dorsi myocutaneous flap was used to cover the defect at damaged leg where vascular pedicle was wrapped by tube flap from the normal leg. External fixators was used to immobilize the bilateral lower legs postoperatively.

Results: Vascular crisis occurred in 3 cases. Vascular crisis was relieved after exploring the vessel.2 cases developed infection at the distal end of flap and cured by debridement. Primary healing was obtained in 11 cases after 2 weeks,and the total survival rate was 100％.The follow-up period lasted for 6 months to 5 years with an average of 3.4 years. The flap appearance was satisfactory and extremity function was restored to normal.

Conclusions: The application of the T type of vascular pedicled latissimus dorsi myocutaneous flap by bridge transplantation is an effective method for repair skin and soft tissue defects in lower extremity without damaging for main blood vessels at contralateral limb, when affected extremities have no available vessel for anastomosis.