The use of combined latissimus-serratus free flap for soft tissue coverage in the hand

Summary A case report is presented on the successful use of a combined latissimus-serratus free muscle transfer in a farmer whose hand was degloved in corn husking bin. There have been no previous reports of the use of such a flap for soft tissue coverage on the hand. The patient was transferred eight days post-injury with an infected wound, a gangrenous thumb and viable fingers. Flap coverage was undertaken four days later. The latissimus dorsi and the lower four slips of the serratus anterior muscle were anastomosed via a common vascular pedicle to the radial artery. The post-operative course was uneventful and donor site morbidity minimal.