ARM SALVAGE PROCEDURE WITH PEDICLED LATISSIMUS DORSI MUSCLE-SKIN FLAP IN HIGH-ENERGY FIREARM INJURIES

Serdar Duzgun; Mehmet Orcun Akkurt; Ahmet Safa Targal; Alpay Duran; ?smail Demirkale

Volume : VII, Issue : VIII, August - 2018

ARM SALVAGE PROCEDURE WITH PEDICLED LATISSIMUS DORSI MUSCLE-SKIN FLAP IN HIGH-ENERGY FIREARM INJURIES

Serdar Duzgun, Mehmet Orcun Akkurt, Ahmet Safa Targal, Alpay Duran, Smail Demirkale

Abstract :

High energy firearm injuries of the upper limb are usually associated with massive soft tissue necrosis, infection, and exposure of the vital structures. Management is fairly problematic, requiring multiple operations and prolonged hospitalization. The latissimus dorsi flap is an anatomically well–known flap that is elevated and transposed using a relatively straightforward surgical procedure. It can be used for large tissue defects and in a functional manner, as needed.

In 7 patients with such injuries, pedicled latissimus dorsi muscle–skin flap have been succesfully used. Mean follow up time was 13,7 months. All flaps survived completely. The donor sites were closed primarily, with acceptable linear scars in all cases.

Pedicled latissimus dorsi musculocutaneous flap provides an excellent cover for upper arm defects. This procedure is a simple, reliable, and extremity–saving method that can be used instead of tissue cover and functional muscle mass when high–energy firearm injuries involving the arm are associated with a vascular injury and repair.