Latissimus dorsi pedicled flap applications in shoulder and chest wall reconstructions after extracompartimental sarcoma resections.

AIMS AND BACKGROUND: In sarcomas of shoulder and of chest wall, latissimus dorsi muscle gives the opportunity to solve any plastic problem without 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 dorsi pedicled flap was used in seventeen patients to reconstruct composite tissue defects after sarcoma resection of the shoulder or of the chest wall. Three groups were recognized. The eight patients of Group I received the flap to close the chest cavity after a multiple rib resection performed to remove a tumor of the chest wall. In Group II four patients had the latissimus dorsi transported to reconstruct the soft tissue coverage over a proximal humerus prosthesis previously applied after 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 patients of the Group II presented a recurrent skin failure. A satisfactory coverage without any flap complication was provided in all the other 15 patients (88%). CONCLUSIONS: Latissimus dorsi pedicled flap represents a reliable and effective technique to reconstruct large chest wall or shoulder soft tissue defects.