Pulmonary atelectasis after reconstruction with a latissimus dorsi myocutaneous flap

The Laryngoscope
M K Wax, J Hurst

Abstract

Atelectasis is the most common postoperative complication encountered in head and neck surgery. Risk factors include preexisting pulmonary disease, type of surgery performed, and the length of anesthetic. It is controversial whether reconstruction of defects with regional myogenous flaps predisposes to atelectasis. The latissimus dorsi myocutaneous flap requires the patient to be placed on his side for a period of time. Whether it is the position or the surgery that contributes to the development of atelectasis has not been examined. Eighteen patients underwent latissimus dorsi myocutaneous flap reconstruction following major ablative procedures for head and neck cancer. The cutaneous area transferred ranged from 70 to 225 cm2 (mean, 128 cm2). The flap size ranged from 7 x 10 to 15 x 15 cm. The majority of flaps were 10 x 15 cm or greater. These patients were compared to 18 patients who did not undergo pedicled myocutaneous chest flap reconstruction. Patients were matched for age, sex, length of operation, site of primary, and stage of disease. Postoperative atelectasis was radiographically detected in 89% of flap patients vs. 79% of controls. Major atelectasis was encountered in 16% of patients undergoing flap surgery vs. 11% ...Continue Reading

References

May 1, 1990·Archives of Otolaryngology--head & Neck Surgery·H SeikalyS J Herman
Feb 1, 1968·The British Journal of Surgery·J A Wightman
Jul 1, 1981·Canadian Anaesthetists' Society Journal·J R Rigg
Mar 1, 1982·Plastic and Reconstructive Surgery·S M BaekH F Biller

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Citations

May 10, 2002·Head & Neck·Kiyotaka UchiyamaKiyonori Harii
Aug 1, 2002·The Laryngoscope·Yoav P TalmiRobert J Shiner

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