Latissimus dorsi pedicle flap for coverage of soft tissue defects about the elbow

Sixteen consecutive patients who were treated with a pedicled latissimus do rsi flap for complex soft tissue defects about the elbow were reviewed The average defect sire was 100 cm(2). Thirteen of the 16 patients achieved sta ble wound healing with a single procedure. Three patients had partial necro sis of the latissimus and required additional coverage procedures. We recom mend that the latissimus dorsi flap should not be routinely used to cover d efects more than 8 cm distal to the olecranon. The flap should be closely m onitored in the first 48 hours, drains should be routinely used at the reci pient and donor sites, and the elbow should be maintained in an extended po sition for the first 5 days after the procedure. The latissimus dorsi flap may also have a prophylactic role in selected patients with compromised sof t tissue coverage about the elbow. The pedicled latissimus flap can be perf ormed under loupe magnification and requires no microsurgical skills or equ ipment.