J Korean Burn Soc.  2021 Dec;24(2):68-73. 10.47955/jkbs.21.0014.

The Usefulness of the Two-Staged Pedicled Latissimus Dorsi (LD) Flap in Fourth-Degree Burns of Upper Extremity

• Kim JH
• Seol SH
• Chung CM
• Park MC
• Cho SH

• KMID: 2522908
• DOI: http://doi.org/10.47955/jkbs.21.0014

Abstract

Purpose
A large defect by fourth-degree burns in the upper limb requires flap reconstruction. Since severe vascular damage and decrease in blood circulation after vascular anastomosis can occur in defects caused by fourth-degree burns. Because of the disadvantages, it is difficult to apply free flap surgery to fourth-degree burns. We reconstructed a upper extremity using the pedicled Latissimus Dorsi (LD) flap in two stages. The purpose of our study is to review our experience and suggest two-staged pedicled Latissimus Dorsi (LD) flap in fourth-degree burns of upper extremities.
Methods
A retrospective review was performed from 2016 to 2019, on a total of 12 fourth-degree burn patients undergone two-staged pedicled LD flap surgery as reconstruction of upper extremities in our hospital. We reviewed the location of the injury, etiology, TBSA (%), size of burns requiring flap surgery, period from 1st surgery to secondary division surgery, complications.
Results
Using two-staged LD flap as a primary reconstruction, the outcome is satisfactory. This flap preserves the elbow joint and maintains the length of the forearm. We obtain low donor-site morbidity, simplicity and a small incision in the donor site.
Conclusion
Using two-staged LD flap in fourth-degree burns of upper extremity is effective, such as preserving elbow joint and maintaining the length of the forearm. Successful reconstruction was achieved with excellent cosmetic results with reducing a postoperative scar, donor-site morbidity. Due to these advantages, two-staged pedicled LD flap can be an optimal option for reconstruction of fourth-degree burns in the upper limb.

Keyword

Two-staged pedicled LD flap; Fourth-degree burn; Upper extremity reconstruction