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APRIL 2015
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The Surgical Technologist
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159
Latissimus Musculocutaneous
Flap for Breast Cancer
Reconstruction
L E A R N I N G O B J E C T I V E S
s
Learn about the history of
autologous breast reconstructions
s
Review the relevant anatomy and
physiology for this procedure
s
Explain the procedure for a
latissimus musculocutaneous flap
for breast cancer reconstruction
s
List the steps for skin preparation
and draping for this operation
s
Recall the post-op treatment
following this type of procedure
Leah-Mar i e Gu i ll , cst
According to the American Cancer Society, more than 288,000 women were diagnosed
with breast cancer in 2011-2012. As the US population continues to age, the prevalence
of breast cancer is expected to continue to increase. Thus, the choice to undergo breast
reconstruction is becoming increasingly commonplace and has proven psychological
benefits for many women. The type and the timing of reconstruction is a multifactori-
al decision based on the need for complementary treatment, lifestyle, desired cosmetic
outcome and preference and experience of the surgeon.
1
B
reast reconstruction techniques have evolved throughout the
past several decades from injection of paraffin directly into
the defect to current advanced techniques such as deep infe-
rior epigastric perforator flaps. As reconstruction has become more
prevalent in the cancer patient population, the search for the most
aesthetically pleasing outcome has gained popularity. Autologous
reconstructions, such as the latissimus dorsi musculocutaneous flap,
provide previously irradiated breasts a cosmetically acceptable out-
come with low risk when a prosthesis and a latissimus flap are used in
conjunction with each other.
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First characterized as a novel approach to repairing breast amputa-
tion in the late 1800s by Italian surgeon, Tanzini, the latissimus dorsi
musculocutaneous flap did not gain popularity until the 1970s when
the surgical approach began to resemble its modern state. Histori-
cally, flap reconstruction was considered unfavorable due to high rates
of capsular contracture. However, with the use of tissue expanders
placed prior to the permanent implant, the rate of capsular contrac-
Restoring Anatomical Features Following Mastectomy