Multimedia
![]() | Media file 1: Elderly man with a recurrent squamous cell carcinoma of the occipital scalp extending to the neck. |
![]() | Media file 2: Close-up view of an elderly man with a recurrent squamous cell carcinoma of the occipital scalp extending to the neck. |
![]() | Media file 3: Defect down to the brain, following wide excision of the tumor. |
![]() | Media file 4: Skin markings showing the planned trapezius island myocutaneous flap to repair defect down to the brain following wide excision of the tumor. |
![]() | Media file 5: Well-settled stable flap covering the defect on the lateral cervical spine and the adjoining scalp. |
![]() | Media file 6: Middle-aged man with squamous cell carcinoma over lateral thoracic and left scapular area, developing from chronic hidradenitis. |
![]() | Media file 7: Defect following wide excision of squamous cell carcinoma over lateral thoracic and left scapular area, developing from chronic hidradenitis. |
![]() | Media file 9: Defect secondary to spina bifida at the thoracic level in a 5-year-old child. |
![]() | Media file 10: Close-up view of defect secondary to spina bifida at the thoracic level in a 5-year-old child. |
![]() | Media file 11: Repair of defect secondary to spina bifida at the thoracic level in a 5-year-old child with bilateral advancement of latissimus dorsi muscles and skin closure. |
![]() | Media file 13: Exposed hardware at the thoracic spine in a middle-aged man. |
![]() | Media file 14: Repair of exposed hardware at the thoracic spine in a middle-aged man with bilateral paraspinal muscle flaps. |
![]() | Media file 15: Young quadriplegic man who has undergone several spinal surgeries with an unstable scar over the thoracolumbar area. |
![]() | Media file 16: Bilateral bipedicle advancement of latissimus myocutaneous flaps is elevated. |
![]() | Media file 17: Lateral relaxing incisions. |
![]() | Media file 18: Flaps are approximated in the mid line to result in a tension-free closure. |
![]() | Media file 19: Two random transposition flaps raised to close a defect in the thoracolumbar area. |
![]() | Media file 20: Result at 2 months, showing stable scar after 2 random transposition flaps were raised to close a defect in the thoracolumbar area. |
![]() | Media file 21: Lumbar defect following excision of melanoma. |
![]() | Media file 22: Closure of lumbar defect following excision of melanoma with 2 rhomboid flaps. |
![]() | Media file 23: Grade IV sacral pressure ulcer in an elderly patient. |
![]() | Media file 24: Reconstruction of grade IV sacral pressure ulcer in an elderly patient with a large, inferiorly based buttock rotation skin flap. |
![]() | Media file 25: Sacral osteoradionecrosis in an elderly woman. |
![]() | Media file 26: Posterior gluteal thigh flap undergoing elevation to repair sacral osteoradionecrosis in an elderly woman. |
![]() | Media file 27: Flap is inset and the secondary defect closed directly to repair sacral osteoradionecrosis in an elderly woman. |
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References
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Hill C, Riaz M. A new twist to the myocutaneous turnover flap for closure of a spinal defect. Plast Reconstr Surg. Sep 1998;102(4):1167-70. [Medline].
Hill HL, Brown RG, Jurkiewicz MJ. The transverse lumbosacral back flap. Plast Reconstr Surg. Aug 1978;62(2):177-84. [Medline].
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Iacobucci JJ, Marks MW, Argenta LC. Anatomic studies and clinical experience with fasciocutaneous flap closure of large myelomeningoceles. Plast Reconstr Surg. Jun 1996;97(7):1400-8; discussion 1409-10. [Medline].
Kato H, Hasegawa M, Takada T, et al. The lumbar artery perforator based island flap: anatomical study and case reports. Br J Plast Surg. Oct 1999;52(7):541-6. [Medline].
Moore TS, Dreyer TM, Bevin AG. Closure of large spina bifida cystica defects with bilateral bipedicled musculocutaneous flaps. Plast Reconstr Surg. Feb 1984;73(2):288-92. [Medline].
Mustarde JC. Reconstruction of the spinal canal in severe spina bifida. Plast Reconstr Surg. Aug 1968;42(2):109-14. [Medline].
Ramirez OM, Ramasastry SS, Granick MS, et al. A new surgical approach to closure of large lumbosacral meningomyelocele defects. Plast Reconstr Surg. Dec 1987;80(6):799-809. [Medline].
Roche NA, Van Landuyt K, Blondeel PN, et al. The use of pedicled perforator flaps for reconstruction of lumbosacral defects. Ann Plast Surg. Jul 2000;45(1):7-14. [Medline].
Thomas CV. Closure of large spina bifida defects: a simple technique based on anatomical details. Ann Plast Surg. Dec 1993;31(6):522-7. [Medline].
Verpaele AM, Blondeel PN, Van Landuyt K, et al. The superior gluteal artery perforator flap: an additional tool in the treatment of sacral pressure sores. Br J Plast Surg. Jul 1999;52(5):385-91. [Medline].
Wendt JR, Gardner VO, White JI. Treatment of complex postoperative lumbosacral wounds in nonparalyzed patients. Plast Reconstr Surg. Apr 1998;101(5):1248-53; discussion 1254. [Medline].
Wilhelmi BJ, Snyder N, Colquhoun T, et al. Bipedicle paraspinous muscle flaps for spinal wound closure: an anatomic and clinical study. Plast Reconstr Surg. Nov 2000;106(6):1305-11. [Medline].
Further Reading
Keywords
back reconstruction, complex posterior trunk defects, posterior trunk defects, trunk repair, muscle-based flaps, perforator-based flaps, free tissue transfer, spina bifida, skin graft, skin flaps, Limberg flaps, rhomboid flap, skin rotation flap, thoracolumbar sacral skin flap, transverse lumbosacral back flap, intercostal neurovascular island skin flap, scapular and parascapular flap, tissue expansion, muscle flap, myocutaneous flap, trapezius flap, latissimus dorsi flap, bilateral advancement flap, bilateral bipedicle myocutaneous flap, latissimus dorsi triangular island advancement flap, serratus anterior, gluteus maximus flap, segmental muscle flap, paraspinous muscle flap, fasciocutaneous flap, paralumbar flap, gluteal thigh flap, perforator flap, periosteal flap, osteocutaneous flap, osteomuscular flap, osseomusculocutaneous flap, omental flap, free flap, innervated flap, filleted leg tissue






















































Multimedia: Back Reconstruction