Authors: Caroline Lilja, MD., Emma Tubæk Nielsen, stud.med., Magnus Balslev Avnstorp, MD., and Stephan Thunich, MD.
Illustrator: Caroline Lilja, MD.

In this chapter, you will learn about the latissimus dorsi flap (LD flap); its anatomy, biomechanical properties, clinical applications and patient assessment, along with a case describing the surgical procedure step-by-step.

Definition

The latissimus dorsi flap (LD flap) is one of the most reliable flaps in reconstructive surgery. It is a secure flap that can be transplanted both pedicled and free. As a pedicled flap, it utilizes the latissimus dorsi muscle, along with overlying dermis and subcutaneous tissue, as a musculocutaneous flap. As a free flap, the preparation can be performed with or without a skin spindle. Moreover, it can be combined with the addition of the 9^th or 10^th rib and used for an vascularized bone graft.¹

Nomenclature

Tansini was the first person to introduce the latissimus dorsi flap in 1906. He described the procedure in his publication “On My New Procedure for the Amputation of the Breast”. During the following years, a radical mastectomy followed by a reconstruction using the latissimus dorsi flap became very popular in Europe. ²

References

1. Little S. C. Latissimus Myocutaneous Flap. Medscape, Clinical Procedures. 17.06.2019. https://emedicine.medscape.com/article/880878-overview#showall 
2. Zampetti P. Merlati G. Rica M. A. Iginio Tansini (1855-1943): An Italian surgeon and an innovator between the 19th and the 20th centruries. Journal of Medical Biography, 2020.