Autologous Reconstruction: Pedicled Flaps
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The latissimus dorsi muscle runs from the thoracolumbar fascia of the lumbar and lower thoracic spine directly under the skin to its base on the upper arm (crista tuberculi minoris). The latissimus dorsi flap, first described by Tansini in 1906, quickly became the standard flap after its rediscovery by Olivari in 1976 due to its very constant anatomy. It can be used as a free flap or as a pedicled flap. In breast surgery it is used almost exclusively pedicled. Even today, the pedicled latissimus is a good procedure if free flaps are not indicated or have failed. The latissimus is an internal rotator and adductor in the shoulder. If the shoulder is intact and the remaining muscles are present, muscle harvesting is usually well tolerated.
Latissimus Dorsi Flap
Pedicled Transverse und Vertical Rectus Abdominis Muscle-Flap (TRAM/VRAM-Flap)
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