Cases of distal latissimus muscle and skin necrosis prompted us to look for an enhanced blood supply in the distal third of the latissimus dorsi and examine the muscular branches of the intercostal vessels. We investigated if one of the lowermost intercostal vessels sends a big enough (>0.5 mm) muscular branch to the latissimus dorsi to serve as a second vascular pedicle for a bipedicled latissimus dorsi free flap. If so, we further asked, whether it was possible to furnish two separate muscle, musculocutaneous, or even perforator flaps out of one latissimus dorsi muscle.
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© 2007 Published by Elsevier Inc.