Use of combined contralateral deltopectoral skin flap and ipsilateral island latissimus dorsi myocutaneous flap for massive cervico-thoracic oesophagus defect repair

Restoring the intestinal continuity of an acquired massive cervico-thoracic oesophagus defect is a reconstructive challenge. A case requiring such defect restoration following a failed pedicled colonic interposition bypass graft between the cervical oesophagus and stomach for an intra-thoracic oesophageal perforation is presented. The defect between the oesophagostome at the lower left neck and the stoma of the colonic stump at the lower left chest measured about 20 cm. An ante-thoracic skin-tube neo-esophagus was constructed in two stages using a pedicled contralateral right deltopectoral skin flap and a pedicled ipsilateral island left latissimus dorsi myocutaneous flap (LD MC flap). A normal swallowing mechanism was re-established.

Repair of thoracic oesophageal perforation with latissimus dorsi flap

Thoracic oesophageal perforation, a life-threatening condition, is a therapeutic challenge. A 20 year old male developed a lower oesophageal perforation following an abdominal cardiomyotomy for achalasia of the lower oesophagus. The resulting suppurative mediastinitis and left empyema thoracis were treated by decortication. The oesophageal perforation was closed using a transposition pedicle left latissimus dorsi muscle flap.

Resurfacing penile skin defect with bilateral dartos musculocutaneous flaps

A case of marked penile skin loss following an adult circumcision is presented. The surgical requirement is to provide a soft and flexible cover for the penis to facilitate return of sensation and function. The two stage bilateral dartos musculocutaneous flaps offer an acceptable surgical alternative.