Anatomical study of muscular latissimus dorsi surface vascularized by the transverse branch of thoraco-dorsal artery

作者：Boucher F^*; Pinatel B; Shipkov H; Mertens P; Rouviere O; Braye F; Mojallal A

来源：Annales de Chirurgie Plastique Esthetique, 2014, 59(5): 327-332.

DOI：10.1016/j.anplas.2014.05.005

• Latissimus dorsi flap
• Muscle-sparing latissimus dorsi
• Thoraco-dorsal artery perforator flap
• Vascular anatomy
• Thoraco-dorsal artery

Introduction. - The latissimus dorsi muscle flap is a type V according to Mathes and Nahai. It is vascularized by a proximal main pedicle represented by the thoraco-dorsal pedicle and pedicle distal accessory represented by the dorsal branches of the posterior intercostal arteries. The main thoraco-dorsal pedicle has a descending branch and a transverse branch. This anatomical study clarifies the muscular territory vascularized by the transverse branch of thoraco-dorsal artery for a secondary use after harvesting a thoraco-dorsal artery perforator flap or a muscle-sparing latissimus dorsi flap.
Material and methods. - Our study focused on ten dissections latissimus dorsi muscle taken from five fresh cadavers chest, carried out within the University Department of Anatomy. The descending branch of thoraco-dorsal artery was ligated, the transverse branch was cannulated and injected with a mixture of barium sulfate/gelatin. After freezing, a static angiotomodensitometrie (3D) of each flap was performed.
Results. - The average muscular surface vascularized by the transverse branch is measured at 80% (77% minimum value, maximum value 83%) of the complete latissimus dorsi muscle. Intermuscular connections between the two branches of thoraco-dorsal pedicle were shown.
Conclusion. - The use of a ipsilateral latissimus dorsi muscle is a therapeutic option after harvesting a thoraco-dorsal artery perforator flap (TAP) or a muscle-sparing latissimus dorsi flap (MSLD-flap).

• 出版日期2014-10