Bilateral interconnected latissimus dorsi-gluteus maximus muscular cutaneous flaps for closure of subfascial infections in lumbar spinal surgery. A technical note.

Abstract

A surgical technique for primary closure of postoperative subfascial infections is described. To describe the methods and indications for the use of the interconnected latissimus dorsi-gluteus maximus flap. Closure of subfascial postoperative infection can be complicated by soft tissue defects and retained implants. Healing by secondary intention is expensive and gives unpredictable coverage of retained hardware. A bilateral interconnected latissimus dorsi-gluteus maximus flap was used to cover resultant soft tissue defects according to techniques previously described for the delayed primary closure of myelomeningocele defects. Stable, durable, drainage-free soft tissue coverage was obtained in all patients treated with this technique. The latissimus dorsi-gluteus maximus flap represents an effective, economical option for the treatment of patients with subfascial infection after instrumented spinal fusion surgery.