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Page 16 of 17 Plast Aesthet Res 2018;5:6 I http://dx.doi.org/10.20517/2347-9264.2018.08

closely monitored and prompt revision is possible. With greater emphasis on early patient discharge, perhaps
more detailed patient education on return precautions is indicated.

26. Pedicled latissiumus dorsi myocutaneous flap for posterior thoracic reconstruction
following eloesser flap takedown: a case series

David Hill

Rush University Medical Center

Pedicled latissimus flaps as the basis for thoracic reconstruction have been utilized for more than a century. While
Dr. Abrashanoff described use of the flap as treatment for complicated bronchopleural fistula in 1911, its use in
remedying iatrogenic chest wall defects resulting from external drainage procedures is less well-documented.
Once medically stabilized, patients surviving chronic empyemas with Eloesser Flaps require reconstruction of
the associated thoracic defect to restore quality of life, which may become of paramount importance. As the
largest extrathoracic muscle flap which may be harvested on a single vascular pedicle, the latissimus dorsi serves
as an ideal myocutaneous flap for obliterating Eloesser Flap defects. Its broad surface area and arc of rotation lend
to coverage with minimal tension while avoiding exacerbation of respiratory mechanics. Although the latissimus
dorsi muscle extends, adducts, and internally rotates the humerus, there are a number of other shoulder girdle
muscles which combine to serve redundant functions, allowing for the muscle to be sacrificed with minimal loss
of strength or form. We present a case series of pedicled latissimus dorsi myocutaneous flaps utilized for Eloesser
Flap reconstruction with excellent aesthetic and functional results.

27. Indocyanine green lymphangiography optimizes the identification and management of
lymphatic leaks in the groin

William Casey, Alanna Rebecca, Raman Mahabir, Lacey Pflibsen, Nadine Hillberg, Claire Jensen

Mayo Clinic - AZ

Aim: The treatment of lymphatic leaks and lymphoceles in the groin can be quite challenging with no
optimal management determined to date. We postulate that ICG lymphangiography improves visualization
of the site of a lymphatic leak and can optimize its management.

Methods: A retrospective review was conducted of all cases in which ICG lymphangiography was used in
the management of lymphatic leaks in the groin over an 18-month span. The inciting surgical procedure
resulting in the leak was determined. Following thorough debridement, ICG was injected intradermally in
the distal extremity and the site of the lymphatic leak was documented (superficial or deep) and oversewn.
Outcomes were reported with regards to healing, infection, time to drain removal, and adjunctive procedures.

Results: Fifteen patients underwent ICG lymphangiography during the surgical treatment of a lymphatic leak
in the groin during the study period. In all cases, the site of the lymphatic leak was accurately identified and
oversewn. In 8 cases, the site of the lymphatic leak was in the subcutaneous tissue superficial to the femoral
vessels rather than medial to the femoral vessels in the area of the lymph node basin. A local muscle flap was
used in 10 cases simultaneously. All wounds healed primarily without an associated wound or infection.