One-stage composite reconstruction using the latissimus myoosteocutaneous free flap.

Head and neck reconstruction using a free flap composed of latissimus dorsi muscle and overlying skin and attached to vascularized posterior rib based on the thoracodorsal vessel was recently developed in our laboratory. Further clinical experience in the use of this flap is presented, along with a detailed explanation of the surgical technique. This flap provides internal lining, structural support, bulk, and external coverage for head and neck defects in one stage. Herein alternative composite free flaps have been compared with this flap.