Boomerang-shaped Lateral-to-back Flap Utilizing Multiple Thoracodorsal Artery Perforators around the Lateral Border of Latissimus Dorsi Muscle for Reconstruction of Large Circular Defect

We herein report the successful reconstruction of an extensive circular skin defect of the elbow region using a boomerang-shaped lateral-to-back muscle-sparing latissimus dorsi myocutanous flap utilizing multiple thoracodorsal artery perforators around the lateral border of the latissimus dorsi. The patient was a 74-year-old woman who presented with pleomorphic sarcoma in the left elbow region. The tumor was extensively resected and the skin defect was 13.5 x 12 cm. The boomerang-shaped lateral-to-back muscle-sparing-latissimus dorsi myocutanous flap was transferred as a free flap with the pedicle vessels anastomosed to the brachial artery and vein. The 2 wings of the boomerang were bent in a U shape to completely cover the skin defect. The donor site was closed primarily. This flap can be a versatile option for reconstructing extensive skin defects in various areas with little donor-site morbidity.