ĐÁNH GIÁ HIỆU QUẢ SỬ DỤNG VẠT DA CƠ LƯNG RỘNG TRONG ĐIỀU TRỊ CHE PHỦ KHUYẾT HỔNG PHẦN MỀM THÀNH NGỰC TẠI VIỆN BỎNG QUỐC GIA VIỆT NAM

Abstract

Introduction: The latissimus dorsi musculocutaneous (LD) flap is a reliable and versatile option for reconstructing chest wall soft tissue defects due to its large surface area, consistent vascular supply, and capacity to cover extensive defects. Objective: To evaluate the effectiveness of the latissimus dorsi musculocutaneous flap in the reconstruction of chest wall soft tissue defects. Subjects and Methods: This was a case series descriptive study conducted on 18 patients with soft tissue defects of the chest wall, who underwent surgical reconstruction using a pedicled latissimus dorsi flap at the Vietnam National Burn Hospital from January 2008 to September 2014. Results: The oblique-axis design of the LD flap was used in the majority of cases (72.22%). The most commonly applied flap technique was the muscle-pedicle flap tunneled under a skin bridge, accounting for 94.44% of cases. The flap rotation angle ranged between 90° and 120° in 77.78% of cases. The average flap width and length were 11.5 ± 0.54 cm and 11.89 ± 0.73 cm, respectively. A high rate of successful flap survival with good wound healing was observed in 94.44% of cases. Delayed wound healing occurred in 12 out of 18 patients. At three-month follow-up, flap condition was stable with soft texture and well-healed scars in 10 out of 11 evaluated patients. The donor site also showed soft and aesthetically acceptable scarring in 9 out of 11 patients. Conclusion: The latissimus dorsi musculocutaneous flap proves to be a highly effective reconstructive option for covering chest wall defects, particularly in cases involving extensive defects or radiation-induced ulcerations. Keywords: chest wall defect, latissimus musculocutaneous dorsi flap