Arch Hand Microsurg 2019; 24(4): 388-393  
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
Correspondence to: Deuk Young Oh
Department of Plastic and Reconstructive Surgery, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, 222 Banpodaero, Seocho-gu, Seoul 06591, Korea
TEL: +82-2-2258-6143, FAX: +82-2-594-7230, E-mail: ohdeuk1234@hanmail.net, ORCID: https://orcid.org/0000-0003-3499-1554
Received: June 13, 2019; Revised: September 10, 2019; Accepted: September 10, 2019; Published online: December 1, 2019.
© Korean Society for Surgery of the Hand, Korean Society for Microsurgery, and Korean Society for Surgery of the Peripheral Nerve. All rights reserved.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
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.
Keywords: Latissimus dorsi, Costochondritis, Breast reconstruction


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