Stefano Bonomi1*, Laura Sala1, Alessandro Gronchi2, Dario Callegaro2 and Umberto Cortinovis2
1Plastic and Reconstructive Surgery Unit, Fondazione IRCCS Istituto Nazionaledei Tumori, Italy
2Sarcoma Surgery Unit, Fondazione IRCCS Istituto Nazionaledei Tumori, Italy
Surgical resection of soft tissue sarcoma of the trunk can result in large defects requiring complex reconstruction for coverage of vital neurovascular structures and tissue defect. Large defects of the back could be reconstructed with multiple random pattern or local pedicled flaps. We present the case of a 48-year-old patient with a locally advanced dermatofibrosarcoma protuberans of the back. Wide local excision of the lesion was performed. The soft tissue defect measured 22 cm x 20 cm x 4 cm and was reconstructed with bilateral reverse latissimus dorsi myocutaneous (RLDM) flap. Each RLDM flap measured 24 cm x 10 cm. The donor site on the back was closed directly on both sides. The patient recovered well and the two flaps healed uneventfully. Twelve months after surgery the patient is disease-free. The use of a RLDM flap in mid-back reconstructions provided wide wellvascularized soft tissue, minimized risk of infection, and maximized back coverage. This flap is an excellent choice for reconstruction of large defects of the mid-back.
Reverse latissimus dorsi myocutaneous flap; Trunk reconstruction; Posterior trunk defect; Sarcoma; Dermatofibrosarcoma protuberans
Bonomi S, Sala L, Gronchi A, Callegaro D, Cortinovis U. Reverse Bilateral Latissimus Dorsi Flap Reconstruction After Extensive Mid Back Dermatofibrosarcoma Protuberans Excision: A Case Report. Clin Surg. 2018; 3: 1857.