A reliable approach to the closure of large acquired midline defects of the back

Journal Article · Sun Oct 01 00:00:00 EDT 1989 · Plastic and Reconstructive Surgery; (USA)

DOI:https://doi.org/10.1097/00006534-198984040-00013· OSTI ID:5466974

Casas, L A; Lewis, Jr, V L ^[1]

---

1. Northwestern Univ. Medical School, Chicago, IL (USA)

A systematic regionalized approach for the reconstruction of acquired thoracic and lumbar midline defects of the back is described. Twenty-three patients with wounds resulting from pressure necrosis, radiation injury, and postoperative wound infection and dehiscence were successfully reconstructed. The latissimus dorsi, trapezius, gluteus maximus, and paraspinous muscles are utilized individually or in combination as advancement, rotation, island, unipedicle, turnover, or bipedicle flaps. All flaps are designed so that their vascular pedicles are out of the field of injury. After thorough debridement, large, deep wounds are closed with two layers of muscle, while smaller, more superficial wounds are reconstructed with one layer. The trapezius muscle is utilized in the high thoracic area for the deep wound layer, while the paraspinous muscle is used for this layer in the thoracic and lumbar regions. Superficial layer and small wounds in the high thoracic area are reconstructed with either latissimus dorsi or trapezius muscle. Corresponding wounds in the thoracic and lumbar areas are closed with latissimus dorsi muscle alone or in combination with gluteus maximus muscle. The rationale for systematic regionalized reconstruction of acquired midline back wounds is described.

• OSTI ID: 5466974
• Journal Information: Plastic and Reconstructive Surgery; (USA), Vol. 84:4; ISSN 0032-1052
• Country of Publication: United States
• Language: English

Related Subjects

63 RADIATION, THERMAL, AND OTHER ENVIRON. POLLUTANT EFFECTS ON LIVING ORGS. AND BIOL. MAT.
62 RADIOLOGY AND NUCLEAR MEDICINE
WOUNDS
HEALING
MUSCLES
RADIATION INJURIES
SURGERY
VERTEBRAE
BIOLOGICAL EFFECTS
BIOLOGICAL RADIATION EFFECTS
BIOLOGICAL RECOVERY
BODY
INJURIES
MEDICINE
ORGANS
RADIATION EFFECTS
RECOVERY
SKELETON
560151* - Radiation Effects on Animals- Man
550600 - Medicine