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The Usefulness of the Two-Staged Pedicled Latissimus Dorsi (LD) Flap in Fourth-Degree Burns of Upper Extremity
Journal of Korean Burn Society 2021;24(2):68-73
Published online December 1, 2021
© 2021 Journal of Korean Burn Society.

Jae Hyun Kim, M.D., Seong Hoon Seol, M.D.1, Chan Min Chung, M.D., Ph.D.1, Myong Chul Park, M.D., Ph.D.1 and Sang Hun Cho, M.D., Ph.D.1

Department of Plastic and Reconstructive Surgery, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, 1Department of Plastic and Reconstructive Surgery, Hallym Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea
Correspondence to: 정찬민, 안양시 동안구 관평로 170길 22 ㉾ 14068, 한림대학교 성심병원 성형외과
Tel: 82-31-380-3781, Fax: 82-31-380-5980
E-mail: cmchung@hallym.or.kr
Received October 19, 2021; Revised November 8, 2021; Accepted November 16, 2021.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
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.
Keywords : Two-staged pedicled LD flap, Fourth-degree burn, Upper extremity reconstruction


December 2021, 24 (2)
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