The Clinical Curative Effect Of The Latissimus Dorsi Musculocutaneous Flap To Repair The Intractable Wounds Of Extremities

Objective To explore the clinical curative effect of the latissimus dorsi musculocutaneous flap to repair the intractable wounds of extremities.Methods The clinical data of 15 patients with intractable wounds of extremities treated by latissimus dorsi musculocutaneous flap were analyzed retrospectively.From December.2009 to April.2016,male 13 cases,female 2 cases,age from 23 to 64,the average age of 44.On the basis of thorough debridement,all cases of soft tissue defects were repaired with latissimus dorsi musculocutaneous flap,14 cases were treated with free flap,and the other was treated with pedicle transfer flap in 15 cases.The flap area was about 13cm×5cm～30cm×15cm.Postoperative,anti-infection,anti-coagulation,anti-vascularspasm,symptomatic treatment.Results The operation of the 15 cases was successful,one case occurred vessel crisis,which turned for the better after emergency operation.,one case had partial necrosis at the distal part,which healed secondarily after dressing change and free skin grafting.15 patients had been followed up for 3～36 months,the average time of 21 months,all wounds were healing satisfaction,no infection and no leakage around the flap,all flaps were skin texture,colour and lustre,good appearance,and function improved,but the flaps were insensitive.Six cases’ two-point discrimination were S3,which anastomosed nerve.Conclusions The latissimus dorsi musculocutaneous flap is suitable for all the refractory wounds caused by all kinds of trauma.It has obvious advantages especially in repairing of infected wounds,chronic osteomyelitis,bone exposure and implant exposed wounds.The latissimusdorsi flap has large area,thick tissue,rich blood supply,which can cover the wound well.According to the requirements of the wound,we can select the muscle flap or combined flap to repair the defect sites,which can fill the wound die cavity and have a strong ability to resist infection.The latissimus dorsi musculocutaneous flap has constant vascular,moderate diameter,small anatomical variation,easy vascular anastomosis,and the survival rate is high.Latissimus dorsi musculocutaneous flap is one of the good choice in repairing refractory wounds of extremities,which can significantly improve the limb salvage rate.