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This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Alberto Terzi Andrea Campione Paolo Scanagatta Permission Requests Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Terzi, A. Articles by Rizzardi, G. Search for Related Content PubMed Articles by Terzi, A. Articles by Rizzardi, G. Related Collections Lung - other Trachea and bronchi Chest wall

Letters to the Editor

Harvest of latissimus dorsi muscle for intrathoracic transposition: is it always necessary to harvest the whole muscle?

Thoracic Surgery Unit, Azienda Ospedaliera S.Croce e Carle – Cuneo, Via Coppino 26, Cuneo 12100, Italy

Received 28 August 2008; accepted 30 September 2008.

^_* Corresponding author. Tel.: +39 0171642480. (Email: alterzi{at}libero.it).

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

We read with interest the paper by Abolhoda et al. about a harvest technique for pedicled transposition of latissimus dorsi muscle, and congratulate the authors [1]. We are used to transpose intrathoracically the whole latissimus dorsi muscle to obliterate an infected apical or mid-thoracic dead space and we use the same technique as described by the authors but we have modified the harvest technique when we use the latissimus dorsi muscle to protect a bronchial stump at risk of bronchial insufficiency.

The latissimus dorsi vasculature is such that vascular supply to the muscle is based on the thoracodorsal vessels. Once these vessels enter the muscle they show a constant division into a horizontal branch and a branch that runs about 2.5 cm medial and parallel to the anterior muscle border [2]; thus an ideal condition for the creation of a split muscle flap with a great rotation arc that can be placed into the chest cavity without tension and can be stuck on the bronchial stump at risk of insufficiency. This split muscle flap is based on the lateral branch only of thoracodorsal vessels that can be easily observed and controlled while raising the flap. This harvest technique is very easy and quicker than the harvest technique required for the whole latissimus dorsi, the bulk of the split muscle flap is such that it can be passed through an intercostal space even without rib resection and the flap is very well vascularised. We have since now used this technique in 13 patients with bronchial stump at risk of bronchial insufficiency with good results and without any complication.

References

1. Abolhoda A, Wirth GA, Bui TD, Milliken JC. Harvest technique for pedicled transposition of latissimus dorsi muscle: an old trade revisited. Eur J Cardiothorac Surg 2008;33:928-930.[Abstract/Free Full Text]
2. Tobin GR, Schusterman M, Peterson GH, Nichols G, Bland KI. The intramuscular neurovascular anatomy of the latissimus dorsi muscle: the basis for splitting the flap. Plast Reconstr Surg 1981;67:637-641.[Medline]

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Alberto Terzi Andrea Campione Paolo Scanagatta Permission Requests Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Terzi, A. Articles by Rizzardi, G. Search for Related Content PubMed Articles by Terzi, A. Articles by Rizzardi, G. Related Collections Lung - other Trachea and bronchi Chest wall