Use of a pedicled flap for reconstruction of extensive soft tissue defects around elbow.

OBJECTIVE To determine the reliability of pedicled latissimus dorsi flap for reconstruction of extensive defects around the elbow in terms of flap survival and coverage of exposed bones, vessels or nerves. STUDY DESIGN Case series. PLACE AND DURATION OF STUDY Department of Plastic and Reconstructive Surgery at Shaikh Zayed Hospital, from February 2003 to January 2008. METHODOLOGY Patients with extensive traumatic wounds around the elbow and wounds secondary to release of postburn elbow contracture were included. Patients above 60 years of age with previous history of myocardial infarct, heart failure, chronic obstructive pulmonary disease or insulin dependent diabetes were excluded. Pedicled latissimus dorsi flap was used for defect reconstruction. Overall flap survival and postoperative complications were the outcome measures. RESULTS There were 28 patients, including 20 males and 8 females, age ranging from 17 to 60 years. Evaluation of the defect considering extent of tissue loss, depth of the defect and exposed vital structure was done. Myocutaneous flap was used in 4 (14%) patients. Muscle only flap was used in 24 patients (86%). Twenty five (90%) flaps survived completely and 3 (10%) had partial loss. Other minor complications were partial graft loss seen in 3 (10%) patients and wound infection seen in 2 (7%) patient. There was no considerable morbidity at donor site and all patients had satisfactory healing. CONCLUSION Pedicled latissimus dorsi flap is a reliable and safe option for resurfacing extensive soft tissue defects of arm, elbow and forearm.