Latissimus dorsi blood supply after thoracodorsal vessel division: the serratus collateral.

The reliability of the latissimus dorsi musculocutaneous flap for breast reconstruction following radical mastectomy and an axillary dissection that may have divided the thoracodorsal vessels is enhanced by preservation of the serratus collateral into the flap. Observations during axillary dissections have confirmed the constant presence of the serratus branch. Primate studies document latissimus dorsi flap viability when elevated on this branch. Studies during microvascular transfer document reversal of flow in the serratus branch to supply the latissimus dorsi muscle after division of the thoracodorsal artery. Latissimus dorsi flap elevation as an island may be reliably based on the serratus branch.