Abstract

Objectives: Extremity injuries are the most common after an earthquake. Reconstruction of large soft tissue defects in the extremities can be difficult for both patients and surgeons. In our study, we aimed to examine the clinical results of patients who underwent chimeric latissimus dorsi-serratus anterior (LD-SA) free flap surgery due to extensive soft tissue defects in the lower extremity.
Methods: We retrospectively reviewed 6 patients (4 women and 2 men) who underwent chimeric LD-SA free flap for large soft tissue defects in the lower extremities. The localization of the patients' soft tissue defects, method of chimeric flap removal, recipient vessels in the donor site, and anastomosis type were noted. Complications, accompanying injuries, and morbidities were evaluated. The defects of the patients were geometrically irregular, and a chimeric LD-SA free flap was applied to all patients.
Results: Six patients who were referred to our clinic and underwent chimeric LD-SA free flap surgery, were evaluated. In 1 patient, the whole leg, medial thigh, and dorsum of the foot; in 3 patients, the whole leg; in 2 patients foot, ankle and distal 1/3 leg were affected. Flap failed in 2 patients and partial necrosis occurred in 1 patient. Three flaps survived.
Conclusion: LD -SA chimeric free flap is an alternative method for covering extensive traumatic lower extremity soft tissue defects that cannot be covered by more commonly performed traditional flaps. Chimeric LD-SA flaps are a good option for large and long defects involving the leg and ankle as they also cover dead spaces in correctly selected patients.

Key words: Chimeric flap, crush extremity injury, earthquake, latissimus dorsi, serratus anterior