Clinical study of Latissimus Dorsi Flap for Various Defects Following Cancer Resections

Introduction: The purpose of reconstruction is to restore every resected tissue and its function, as well as to achieve primary wound healing so that rehabilitation and adjuvant therapy can begin as soon as possible. It is no longer enough to simply close a wound in modern reconstructive surgery. It's critical to aim for the absolute best functional and aesthetic outcomes. Aims: To evaluate the role of latissimus dorsi flap in reconstruction of Various defects following cancer resections in arm, axilla, shoulder, chest wall, breast, head and neck and scalp. Materials and methods:It is a prospective study in Twenty patients with cancers were identified during the study period of one year after thorough workup and after obtaining fitness for anaesthesia, the patients and their attendants are explained about the surgical ablative procedure and the reconstructive procedure contemplated. Results: In this study 20 cases the role of using latissimus dorsimyocutaneous flap (LDMF) for soft tissue defects involving breast, chest wall, shoulder and arm was explored. The patients were in the age range of 24 to 80 years. Maximum flap dimension was 30 X 20 cms. All patients underwent immediate reconstruction of the primary defect. In our series out of 20 patients, 13 flaps had healed primarily without flap congestion, margin necrosis, or infection, 3 flaps had medial edge necrosis of about 3-4cms which were debrided and closed primarily. These 3 flaps were extremely large and the lumbar extension of the flap was done to cover the defect. Seroma formation was seen in 3 patients. Out of the 2 cases closed primarily in 1 case donor site had seroma formation which was managed conservatively by serial aspiratons and drain was kept in situ for about 18 days and compression dressing was done with dynaplast application. Out 20 cases 2 patients had recurrence through the inferior aspect of the flap. Conclusion: Additional care and precautions donor site morbidity can be reduced and overall, the donor site is well tolerated and the patients are functionally satisfied with the reconstruction