PR13THE USE OF PEDICLED LATISSIMUS DORSI FLAPS IN LARGE CHEST WALL RECONSTRUCTION

To report a challenging case of reconstructing a massive chest wall defect. To demonstrate the usefulness of the pedicled latissimus dorsi flap to reconstruct massive sternal wounds. Case Report - A 35 year old man presented 2 weeks after a chest wall resection for a primary amyloidoma and reconstruction using a combination of a titanium mesh and Gore-tex soft tissue patch with primary skin closure. He was clinically septic, with the primary focus being the chest wound. The infected Gore-tex and titanium mesh were removed, and the cavity debrided, resulting in a chest wall defect measuring 30 cm (subcutaneous width) times 20 cm (height) and a bony defect measuring 15 cm (width) times 18 cm (height). An initial attempt of reconstructing this with a free latissimus dorsi flap was abandoned prior to raising of the flap because of difficulty in finding a recipient vessel. The defect was finally reconstructed using a pedicled latissimus dorsi flap. We describe a single stage technique for reconstructing a massive sternal defect. The use of a pedicled latissimus dorsi flap provided a reliable reconstruction in what can be a traditionally difficult reconstructive site. A pedicled latissimus dorsi flap is useful even in the reconstruction of large chest wall defects. [PUBLICATION ABSTRACT]