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KMID : 0358819850120030439
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Journal of Korean Society of Plastic and Reconstructive Surgeons
1985 Volume.12 No. 3 p.439 ~ p.444
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THE USAGE OF LATISSIMUS DORSI MYOCUTANEOUS FLAP, LIGATED THORACODORSAL ARTERY
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Shin Keuk-Shun
Kim Jong-Hwan
Lee Sang-Heon
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Abstract
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Following radical mastectomy, the latissimus dorsi myocutaneous flap has been used for reconstruction of breast or chest wall.
In the standard radical mastectomy of Halsted method, axillary dissection is usually performed. However, thoracodorsal vessels to supply the latissimus dorsi muscle be damaged during axillary lymph nodes dissection.
There have been two perplexing questions in the use of the latissimus dorsi myocutaneous flap (1) Was the thoracodorsal vascular pedicle ligated during axillary dissection? (2) If so, can the flap still be used, this latissimus dorsi myocutaneous flap has been used for chest wall reconstruction from the early of 20th century, but believed that the thoracodorsal vessels should be preserved.
Recently Maxwell et al. (1979)and Fisher et al. (1983) reproted that latissimus myocutaneous flap could be survived afer division of thoracodorsal artery and used as a flap. Then we applicated this flap to the chest wall reconstruction of radiated ulcer patients after radical mastectomy. Those patients were confirmed the division of thoracodorsal artery and collateral circulation around insertion area of latissimus muscle and serratus branch to supply the latissimus dorsi muscle by angiogram preoperatively.
We report that this latissimus dorsi myocutaneous flap divided the thoracodorsal vessels could be survive with help of regional collateral circulation clinically.
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KEYWORD
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