Extended V-Y latissimus dorsi musculocutaneous flap for anterior chest wall reconstruction

Patients presenting advanced breast tumors are usually subject to major res ections of the anterior chest wall tissue. Flaps taken from the abdominal w all, such as the TRAM, the external oblique flap, and the thoracoabdominal flap are frequently used for closure of this type of lesion. In this study, a different shape tvas planned for the skin island from the latissimus dor si musculocutaneous flap with primary closure in V-Y for the correction of major lesions in the anterior chest wall after mastectomies occasioned by a dvanced breast cancer. The technique was used on eight female patients, bet ween November of 1998 and July of 1993, victims of advanced breast cancer, who had been submitted to radical mastectomies with major resections of the cutaneous tegument. It was possible to make primary closure of lesions in the anterior chest wall, the preoperative areas of which varied between 15 x 15 and 29 x 14 cm (vertical X horizontal). This technical variant permitt ed use of the flap without the need to create tunnels for its advancement a nd rotation. It also proved to be easy to perform and presented a low morbi dity rate, with three patients presenting minor complications that did not require correction through any further surgical intervention. Closure was o btained in the donor and recipient sites without the use of skin grafts or other more major procedures. According to the authors, this procedure is a viable alternative in repairing large defects in the anterior chest wall.