fig4

Figure 4. Anatomy of dissection for pedicled latissimus dorsi flap, demonstrating relevant muscular and neurovascular anatomy, including (*) subscapular, (^) circumflex scapular, (#) thoracodorsal, (>) angular, (+) serratus anterior, and ($) latissimus dorsi vessels. Also depicted are the brachial plexus (1), axillary artery (2), and axillary vein (3). The latissimus dorsi pedicle is isolated from other vascular branches, while the latissimus dorsi muscle is transected to free it both posteriorly and superiorly at the humeral attachment. The muscular flap is then tunneled superficial to the pectoralis major, over the clavicle and through the pectoralis major.