Value of the skin and muscle pedicle in myocutaneous flaps

The value of a combined skin and muscle pedicle as opposed to the purely muscular pedicle is discussed using the example of the myocutaneous island skin flap of the M. latissimus dorsi in the neck-, shoulder-, and upper arm region. There is an indication scheme for the choice of flap pedicle depending on the tension and kinking of the flap or possible previous damage of the muscle pedicle.