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How-to-do-it

Harvest technique for pedicled transposition of latissimus dorsi muscle: an old trade revisited

^a University of California, Irvine, Medical Center, Department of Surgery, Division of Cardiothoracic Surgery, Orange, CA, United States
^b University of California, Irvine, Medical Center, Department of Surgery, Orange, CA, United States

Received 13 July 2007; received in revised form 21 December 2007; accepted 16 January 2008.

^_* Corresponding author. Address: Division of Cardiothoracic Surgery, Department of Surgery, University of California, Irvine Medical Center, 101 The City Drive, Building 53, Room 117, Orange, CA 92868-3298, United States. Tel.: +1 714 456 3634; fax: +1 714 456 8870. (Email: aabolhod{at}uci.edu; gwirth{at}uci.edu; buitd{at}uci.edu; jmillik{at}uci.edu).

Transposition of extrathoracic muscle flaps has been the cornerstone of treatment of a number of complex intrathoracic pathologies such as bronchopleural fistulas and residual infected pleural spaces. We present a simple step-wise technique for preservation and harvesting of the most common muscle flap employed by thoracic surgeons, namely latissimus dorsi, just prior to performing a standard posterolateral thoracotomy. Since 2004, we have successfully utilized pedicled latissimus muscle as our preferred prophylactic flap against development of postoperative bronchopleural fistulas or recurrent empyemas. This technique should be part of every thoracic surgeon's surgical armamentarium.

Key Words: Latissimus dorsi muscle flap • Harvest technique • Thoracic surgery