The reverse latissimus dorsi flap for lumbar defects.

We surely agree with them that the procedure can be long and that it submits the patient to a larger surgical trauma compared with the reverse latissimus dorsi flap, which we find anyway a valid and in some cases very indicated reconstructive option. The point is that we used the prolonged flap in patients affected by multiple recurrences in the lumbar or sacral areas where several other procedures had been tried before and therefore several former incisions were already present. Furthermore, mostly in the sacral region, the reverse latissimus dorsi flap can be too short to obtain a tension-free, and therefore stable, coverage of the defect.