Atlas of Latissimus Dorsi Flap

Dr. Alessandro Thione is a plastic and reconstructive surgeon with particular expertise in microsurgery, hand surgery, trauma, and replantation surgery. He completed his medical education at the University of Insubria in Italy and currently serves as Head of the Plastic and Reconstructive Surgery Section at La Fe Hospital in Valencia, Spain. In over a decade of clinical experience, Dr. Thione has performed thousands of complex surgical procedures and remains actively involved in advancing reconstructive techniques. He has authored numerous scientific publications and contributed chapters to several internationally recognized medical textbooks, particularly in the areas of trauma and replantation surgery. Committed to education, Dr. Thione is dedicated to training and mentoring young surgeons.Dr. Alberto Pérez-García is a board-certified plastic and reconstructive surgeon at the Hospital Universitari i Politècnic La Fe in Valencia, Spain. His clinical focus lies in microsurgery, oncologic reconstruction, and complex soft tissue repair. Dr. Pérez-García has co-authored over 50 peer-reviewed publications and contributed chapters to several surgical textbooks, with a focus on reconstructive techniques for large oncologic defects, hemipelvectomy, and perineal reconstruction. His work includes the use of extended vertical rectus abdominis myocutaneous (eVRAM) flaps for complex pelvic and perineal reconstructions, and innovative applications of chimeric flaps in hemipelvectomy cases. Dr. Pérez-García is actively involved in clinical research and surgical education, mentoring residents and fellows in advanced reconstructive techniques. His expertise in managing extensive oncologic and traumatic defects makes him a valuable collaborator for research proposals focused on reconstructive surgery and surgical innovation.Dr. Belén Andresen Lorca is a plastic and reconstructive surgeon with specialized training in microsurgery, breast reconstruction, and facial rejuvenation, presently resident at Hospital Universitari i Politècnic La Fe in Valencia, Spain. She has completed clinical rotations at leading institutions, including Beaumont Hospital in Dublin, Ireland, and Charles University in Prague, Czech Republic. Her clinical training encompasses a broad spectrum of reconstructive procedures, with particular focus on trauma surgery, microsurgical techniques, and complex soft tissue reconstruction. Dr. María García García is a board-certified plastic and reconstructive surgeon in the Department of Plastic Surgery and Burns at Hospital Universitari i Politècnic La Fe in Valencia, Spain. Dr. García García has been actively involved in clinical research and has contributed to several peer-reviewed publications and textbook chapters. She is particularly interested in advancing surgical techniques and improving patient outcomes through innovation and multidisciplinary collaboration.

• Preface.- 1. Introduction: Historical background, Evolution of flap surgery, Rationale for using the latissimus dorsi flap.- 2. Surgical Anatomy of the Latissimus Dorsi Muscle: Origin, insertion, and function, Vascular supply: thoracodorsal system, Innervation and lymphatic drainage, Anatomical variations.- 3. Flap Classification and Variants: Myocutaneous, muscle-only, and perforator flaps, Extended latissimus dorsi flap, Chimeric and combined flaps.- 4. Preoperative Planning. Patient selection, Imaging and vascular assessment, Marking and positioning, Risk assessment and contraindications, 5. Surgical Technique: Harvesting the Flap: Positioning and incision, Dissection planes, Pedicle isolation, Flap transfer and insetting, Donor site management.- 6. Reconstructive Indications and Applications: Breast reconstruction (immediate and delayed), Head and neck reconstruction, Upper and lower extremity reconstruction, Chest wall and trunk defects, Pediatric and trauma applications of LD flap.- 7. Microsurgical Considerations: Thoracodorsal pedicle characteristics, Recipient vessel selection, Microvascular anastomosis techniques.- 8. Postoperative Care and Rehabilitation: Flap monitoring protocols, Management of drains and seroma prevention, Physical therapy and functional outcomes.- 9. Complications and Their Management: Donor site morbidity, Flap failure and salvage strategies, Seroma, hematoma, and infection, Functional impairment.- 10. Outcomes and Long-Term Results: Functional and aesthetic outcomes, Patient-reported outcomes, Quality of life assessments.- 11. Future Directions and Innovations: Robotics and endoscopic-assisted harvest, 3D planning and virtual surgical simulation, Regenerative approaches and composite tissue engineering.- 12. Case Series and Clinical Pearls: Representative cases with photos and discussion, Lessons learned and technical tips, Algorithmic approach to flap selection.- Back Matter (Appendix): Surgical checklists, Anatomy tables, Glossary of terms.