TISSUE PLASTIC OF HEAD AND NECK DEFECTS WITH ARTERIALIZED TRANSPLANT ON THE BASE OF LATISSIMUS DORSI MUSCLE

Restoration of deformed tissues and organs of the human body has always been relevant to the wide range of medical and social problems of humanity. Head and neck damage are especially difficult for functional and cosmetic restoration. The high level of injuries, destructive power of modern weapons as well as the increasing of number of oncological diseases, cause the presence of heavy categories of patients with combined extensive injuries. Treatment and rehabilitation of such patients is an actual and, at the same time, a complex problem of modern medical science and practice. Replacement of large tissue defects with complicated autotransplants on microvascular anastomosis has become widespread in plastic surgery in recent years. Our study focuses on clinical and morphological argumentation of transplants based on the latissimus dorsi muscle. Morphological studies were performed on twenty anatomical specimens (unfixed corpses). We used the classical methods of anatomical dissection, X-ray angiography, spatial reconstruction of donor’s zone of bloodvessels channel with usage of anatomic corrosion preparations (Ukrainian Medical Stomatological Academy, Department of Topographic Anatomy). In clinic, eighteen restoration and reconstructive surgery operations were performed using arterialized transplants based on latissimus dorsi muscle in patients with extensive injuries of the head and neck (Moscow, CSRIS). Patients with extensive injuries, defects and deformities of the head and neck belong to particular clinical group of patients, the treatment and rehabilitation of which is a challenge for surgeons. As a rule, extensive defects of the head, face and neck are accompanied by tissue damage. In order to restore these tissues a plastic material of thick and large area, including skin, fat, muscles, and bone should to be found. According to our clinical and morphological studies, the authorized transplants based on the latissimus dorsi muscle can be successfully applied to the restoration of combined extensive head and neck damage with the usage of microvascular anastomoses. The satisfactory data of such plastic recovery operations were clinically confirmed.