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Arch Hand Microsurg > Volume 24(4); 2019 > Article
Archives of Hand and Microsurgery 2019;24(4):388-393.
Published online December 1, 2019.
Using a Pedicled Latissimus Dorsi Musculocutaneous Flap to Treat Infective Costochondritis Following Breast Reconstruction Using an Implant
Jun Hyeok Kim, Seung Eun Baek, Deuk Young Oh
Department of Plastic and Reconstructive Surgery, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Received: 13 June 2019   • Revised: 10 September 2019   • Accepted: 10 September 2019
Infectious costochondritis seldom occurs after breast reconstruction. The treatment requires wide debridement, appropriate wound cover, and antibiotic therapy. A 53-year-old female patient was referred due to an unhealed right breast wound. She had undergone right skin-sparing mastectomy followed by breast reconstruction with an implant. Pseudomonas aeruginosa was cultured from the wound discharge, and a computed tomography showed fluid collection underneath the pectoralis muscle with connection to the external opening as well as degenerated T4–T6 costal cartilages. Wide excision of infected tissue and costal cartilages followed by a pedicled latissimus dorsi musculocutaneous flap coverage were performed. The mastectomy wound allows a wider surgical view to prepare thoracodorsal vessels, and the harvesting the latissimus dorsi musculocutaneous flap can be more easily performed without excessive traction force or damage on pedicles. The coverage of pedicled flap was successful and the patient was injected antibiotics intravenously for 3 weeks without any postoperative complications.
Key Words: Latissimus dorsi, Costochondritis, Breast reconstruction

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