Latissimus Dorsi Muscle Harvest

Muscle flaps have multiple applications in thoracic surgery. Among the available flaps, the latissimus dorsi muscle flap is of special interest because of its unique characteristics, such as its large volume, making it suitable for filling pleural spaces, its constant pattern of vascular supply, and its wide arch of rotation, enabling transposition to different regional sites in the chest, back, and neck, thus eliminating the need for vascular microanastomosis in virtually all applications within the chest. Also, after division of the dominant vascular pedicle, the latissimus dorsi can be prepared as an inverted flap and used for reconstruction of the diaphragm. The latissimus dorsi muscle flap is useful for myoplasty of infected pleural spaces and bronchial fistulas, as well as for reconstruction of large soft tissue defects. The latissimus dorsi can be used either as a simple muscle flap or as a musculocutaneous flap. It is well suited to be used locally but also as a free flap with microvascular anastomosis in remote areas of the body. This paper presents the technique of harvesting the latissimus dorsi muscle flap and provides clues for its effective application in different clinical scenarios.