A Pedicle-Lengthening Technique for Free Latissimus Dorsi Muscle Flaps: The “Y-V-I” Principle

ABSTRACT

This article describes a pedicle-lengthening procedure (the Y-V-I principle) that reverts a Y-shaped vascular structure into an I-shaped vascular structure, and its application to the latissimus dorsi muscle. If the Y-shaped vascular structure is divided proximal to the branching point and ligated, it becomes a V-shaped vascular structure. To obtain a linear I-shaped vascular structure, the V is opened, and the length of the vascular pedicle will become equal to the combined length of both limbs of the V. This report indicates that the latissimus dorsi flap may be transferred based on the circumflex scapular artery or the serratus branch.

KEYWORDS

Latissimus dorsi muscle - pedicle-lengthening-flap

REFERENCES

• 1 Rowsell A R, Davies D M, Eisenberg N, Taylor G I. The anatomy of the subscapular-thoracodorsal arterial system:study of 100 cadaver dissections.  Br J Plast Surg. 1984;  37 574-576
• 2 Bartlett S P, May Jr J W, Yaremchuck M S. The latissimus dorsi muscle: a fresh cadaver study of the primary neurovascular pedicle.  Plast Reconstr Surg. 1981;  67 631-636
• 3 Martin D, Legaillard P, Bakhach J, Hu W, Baudet J. Reverse flow Y-V pedicle extension: a method of doubling the arc of rotation of a flap under certain conditions.  Ann Chir Plast Esthet. 1994;  39 403-414
• 4 Fisher J, Bostwick J, Powell R W. Latissimus dorsi blood supply after thoracodorsal vessel division: the serratus collateral.  Plast Reconstr Surg. 1983;  72 502-511
• 5 Caffee H H. Transfer of the scapular flap on a reverse latissimus muscle pedicle.  Plast Reconstr Surg. 1998;  101 85-89
• 6 Robb G L. Thoracodorsal vessels as a recipient site.  Clin Plast Surg. 1998;  25 207-211
• 7 Shimizu T, Ohno K, Michi K, Segawa K, Takiguchi R. Morphometric examination of the free scapular flap.  Plast Reconstr Surg. 1997;  99 1947-1983