Combined transposition of the latissimus dorsi and serratus anterior muscles in cervical and thoracic reconstructive surgery. Results of 40 anatomical dissections and clinical applications in 21 cases
Guédon, C.; Vu, P.; Gehanno, P.; Andreassian, B.; Soussaline, M.
Annales de Chirurgie Plastique et Esthetique 33(4): 321-328
1988
ISSN/ISBN: 0294-1260 PMID: 2465719 Document Number: 310707
The results of 40 dissections confirm the consistent presence of a branch of the thoracodorsal artery to the serratus anterior muscle and demonstrates that the distal vascular pedicle arrangement permits the transposition of the lower muscle digits to the head and neck on a long vascular pedicle without vascular anastomoses. This study also demonstrates that an extended serratus anterior myocutaneous flap can be obtained by including the lateral thoracic pedicle. The combined transposition of latissimus dorsi and serratus anterior was varried out on a series of 21 patients presenting unusual head and neck thoracic reconstruction prblems herein described. The operative technique is described, stressing the need for an atraumatic dissection. This combination flap proved its reliability and versability in closure of extensive compound defects. The advantages and drawbacks of the flap are discussed. Deficit of the serratus anterior muscle may cause instability and "winging" of the scapula. Functional disabilities will be minimal if only a part of the lower portion of the serratus anterior muscle is removed. This series confirms that this flap can provide and attractive solution to a range of challenging head and neck or thoracic reconstruction problems.