Large radiation wounds or defects of the posterior aspect of the leg require vascularized tissue to heal. The free latisimus flaps offer long vascular pedicles, a significant amount of muscle for coverage.
When no vessels are available in the lower extremity, free tissue transfer can be performed by anastamosing the latisimus muscle flap to the popliteal artery and a saphenous vein branch for arterial outflow.
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