A total of 17 patients (6 women, 11 men) were operated using a pedicled LDMF in the Plastic and Reconstructive Surgery Department of a tertiary care center between 2010 and 2014.
Criteria for the use of the pedicled LDMF consisted of the presence of comorbidities in all patients (100%), advanced age (>65 years) in eight (47%), tumor recurrence in four (23.5%), history of radiotherapy in three (17.6%), and failure of the free flap in two (11.8%).
Even though the thoracodorsal nerve was transected during the harvest of the pedicled LDMF, a bulky mass appeared on the clavicle postoperatively.
In these conditions, the use of an LDMF for reconstruction may prove to be vital (2, 4, 5).
In other words, indications for a pedicled LDMF may be limited.
A pedicled LDMF is superior to other pedicled flaps as it is wider and has a larger rotational arc in addition to a longer, consistent pedicle.
In our series, no restriction of the rotational arc was observed owing to the preparation of the pedicled LDMF with a distal and extensive skin island.
The anterior transfer of a pedicled LDMF can be accomplished via subclavicular or subcutaneous approaches and the pectoralis tunnel and transaxillary subclavian routes.