LATISSIMUS-DORSI PEDICLED FLAP APPLICATIONS IN SHOULDER AND CHEST-WALL RECONSTRUCTIONS AFTER EXTRACOMPARTMENTAL SARCOMA RESECTIONS

Aims and background: In sarcomas of shoulder and of chest wall, latiss imus dorsi muscle gives the opportunity to solve any plastic problem w ithout recourse to free flaps. The authors report their experience in the use of latissimus dorsi pedicled flap as adjuvant procedure in the surgery of bone and soft tissue sarcoma. Methods: The latissimus dors i pedicled flap was used in seventeen patients to reconstruct composit e tissue defects after sarcoma resection of the shoulder or of the che st wall. Three groups were recognized. The eight patients of Group I r eceived the flap to close the chest cavity after a multiple rib resect ion performed to remove a tumor of the chest wall. In Group II four pa tients had the latissimus dorsi transported to reconstruct the soft ti ssue coverage over a proximal humerus prosthesis previously appiled af ter bone tumor resection. The five patients of Group III had the flap performed at the same time of the resection of a tumor arising in the shoulder area (1 bone and 4 soft tissue sarcoma). Results: Two patient s of the Group II presented a recurrent skin failure. A satisfactory c overage without any flap complication was provided in all the other 15 patients (88%). Conclusions: Latissimus dorsi pedicled flap represent s a reliable and effective technique to reconstruct large chest wall o r shoulder soft tissue defects.