A Free Ultrathin Latissimus Dorsi Perforator Flap (LDPF) for Reconstruction of Soft Tissue Defect in the Hand

A free ultrathin latissimus dorsi perforator flap (LDPF) was first used to reconstruct the soft tissue defect in the hand at Chang Gung Memorial Hospital in Taiwan. A 60 year-old male patient with soft tissue defect over dorsum of right hand underwent microsurgical LDPF reconstruction. The size of this flap was 24×9 cm. The flap survived well. The hospital stay was 12 days. The donor site was closed primarily. At a mean follow-up of 4 months, no complication and donor site morbidity were found. LDPFs have the following advantages: (1) constant anatomy and thin thickness feature (2) the diameter of the pedicle compatible with that of the recipient vessels of the hands, (3) good color and aesthetic match to hand, (4) low donor site morbidity than conventional latissimus dorsi flaps, (5) achieving protective sensation without nerve anastomosis, (6) scar of donor site hidden in the clothes and, (7) two teams work well simultaneously. We conclude that LDPFs provide another option of free thin flaps for reconstruction of soft tissue defect in the hand.