The Pentagonal Modification of the Pedicled Latissimus Dorsi Myocutaneous Flap for Chest Wall Sarcoma Reconstruction

Singh, P; Hu, M; Overland, J; Gearing, P; Sharma, A; Snow, H; Jackson, B; Sheikh, R; Webb, A; Zinn, R

Author(s): Singh, P; Hu, M; Overland, J; Gearing, P; Sharma, A; Snow, H; Jackson, B; Sheikh, R; Webb, A; Zinn, R;
Details: Publication Year 2026-08,Volume 97,Issue #2,Page 213-217
Journal Title: Annals of Plastic Surgery
Publication Type: Case report
Abstract: The myocutaneous latissimus dorsi is a workhorse flap, providing robust, reliable, and composite tissue for extensive chest wall resurfacing. In this paper, we will illustrate the advantages of a pentagonal design with a V-Y modification using a reconstructive case series of 5 vignettes with chest wall defects resulting from sarcoma resection, and summarise the literature on this modification. The advantages of this technique are to: (1) maximize the available skin paddle and avoid unnecessary skin bridges. (2) Maintain V-Y advancement options for the flap, rather than the conventional rotational inset. (3) Minimize the risk of failure of closure of the large donor site. (4) Allow for a broader and wider flap harvest than conventional approaches. (5) Bring nonirradiated tissue into the reconstructed defect. These advantages are important in preserving as much reconstructive local tissue as possible, particularly in cases of extensive resection, as with sarcoma, or in irradiated tissue, in which maximizing vascularity and locoregional flap-based reconstruction is a priority.
Publisher: Wolters Kluwer
Keywords: Humans; *Thoracic Wall/surgery; *Myocutaneous Flap/transplantation; *Superficial Back Muscles/transplantation; *Sarcoma/surgery; *Plastic Surgery Procedures/methods; *Thoracic Neoplasms/surgery; Male; Female; Middle Aged; Adult; Aged; LD flap; angiosarcoma; chest wall reconstruction
Department(s): Surgical Oncology
Publisher's Version: https://doi.org/10.1097/sap.0000000000004766
Terms of Use/Rights Notice: Refer to copyright notice on published article.

Creation Date: 2026-05-21 11:17:46

Last Modified: 2026-08-06 02:27:25