A Pedicle-Lengthening Technique for Free Latissimus Dorsi Muscle Flaps: The ‘‘Y-V-I’’ Principle

This article describes a pedicle-lengthening procedure (the Y-V-I principle) thatreverts a Y-shaped vascular structure into an I-shaped vascular structure, and its applicationto the latissimus dorsi muscle. If the Y-shaped vascular structure is divided proximal to thebranching point and ligated, it becomes a V-shaped vascular structure. To obtain a linearI-shaped vascular structure, the V is opened, and the length of the vascular pedicle willbecome equal to the combined length of both limbs of the V. This report indicates that thelatissimus dorsi flap may be transferred based on the circumflex scapular artery or theserratus branch.KEYWORDS: Latissimus dorsi muscle, pedicle-lengthening-flap

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