To explore the improvement and clinical application of bridged free latissimus dorsi musculocutaneous flap.

Between January 2012 and January 2018, 12 patients with soft tissue defect of the leg were treated with bridged free latissimus dorsi musculocutaneous flap. There were nine males and three females. They ranged in age from 22 to 52 years, with a mean age of (36.6±5.3) years. The size of the soft-tissue defects of the leg ranged from 26 cm×9 cm to 41 cm×10 cm. After the soft tissue defect of the leg was repaired with the musculocutaneous flap, the thoracodorsal artery and vein were anastomosed to the contralateral fibular artery and the large saphenous vein. The vessel pedicles were repaired with a meshed split-thickness free skin graft.

All the musculocutaneous flaps survived completely. No clinical vascular deficiency was found on the musculocutaneous flap postoperatively. 1 case occurred small superficial infection at the distal part of the musculocutaneous flap, which spontaneously healed after 2 weeks of dressing changes. The follow-up period ranged from 1.5 to 4.5 years, with a mean of (3.8±5.3) years. A good contour was confirmed at the recipient area. There was no obvious morbidity at the donor site. The therapeutic effect was evaluated by the method for tibia fracture. The therapeutic effect was excellent in 7 cases, good in 4 cases, and fair in 1 case. Satisfactory clinical results were obtained in this series.

Bridged free latissimus dorsi musculocutaneous flap is suitable for the treatment of soft tissue defects of the leg with only one major blood vessel, which can reduce the damage to the donor site of the leg.