ePlasty: Vol. 17
Salvage Operation Using the Free Latissimus Dorsi Muscle Flap for Necrosis of the Free Scapular Flap After Harvesting Both Flaps in a Chimeric Pattern
Naohiro Ishii, MD, PhD, Shigeki Sakai, MD, PhD, and Kazuo Kishi, MD, PhD

Department of Plastic and Reconstructive Surgery, Keio University, Tokyo, Japan

Correspondence: ishinao0916@gmail.com
Keywords: free flap, salvage, chimeric flap, perforator, microsurgery


We describe the case of a 39-year-old man with a diabetic ulcer on his left heel and proximal plantar surface. After debridement of the ulcer and bone abrasion, we planned reconstruction with a free scapular flap.


1. What complications are associated with small skin perforators?

2. How is a free chimeric flap secured during salvage operation?

3. What has a free chimeric flap been used for to date?

4. In what other flaps can you apply the present technique?


In free-flap surgery, small skin perforators can show strong spasm or become inadvertently injured during dissection, traction, or coagulation. However, it is sometimes difficult to decide whether the injured small perforator flaps can be used with the injured skin perforator despite waiting for recovery from the injury. Furthermore, there have been only .......