ABSTRACT

The first use of a pedicled latissimus dorsi flap for reconstruction in the head and neck area was described by Quillen in 1978. Watson reported the first successful microvascular transfer of a free latissimus flap in 1979 and exploited a wide variety of applications for head and neck reconstruction. The latissimus dorsi flap can be used either as a pedicled flap or as a free flap. The length of the pedicle is generous and even as a pedicled flap, most defects of the head and neck area can be reached after the flap is passed through the axilla and then between the pectoralis minor and major muscles of the chest wall. By exteriorizing the pedicle, even posterior scalp defects may be reconstructed. The total area covered by the latissimus dorsi muscle is approximately 25 cm × 40 cm. The maximum size of the skin paddle that can be transferred is naturally determined by the size of the particular patient.