S.W.A.T. flap in plastic surgery - The latissimusdorsi. In-depth overview of a classic weapon and systematic review of its reported uses

Sep 28, 2026

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The latissimus dorsi (LD) flap is presented as the “S.W.A.T. flap” in reconstructive surgery, emphasizing its exceptional versatility and adaptability for complex, high-risk defects. Multiple dissection techniques and patient positioning options broaden its utility across multidisciplinary settings. Harvesting can include different tissue compositions (muscle, skin, bone, adipose) and multiple vascular configurations via a consistent thoracodorsal pedicle. A systematic PRISMA-guided review synthesizes reported uses across clinical scenarios.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages12

Reading Time30 min

AccessFree to download

Introduction

Uses of latissimus dorsi flap

Systematic review (PRISMA-guided)

Conclusion

JPRAS Open 48 (2026) 269–280 Contents lists available at ScienceDirect JPRAS Open journal [homepage:](homepage: www.elsevier.com/locate/jpra)[ www.elsevier.com/locate/jpra](homepage: www.elsevier.com/locate/jpra) Review Article S.W.A.T. ﬂap in plastic surgery: The latissimusdorsi. In-depth overview of a classic weapon and systematic review of its reported uses. Belén Andresen-Lorcaa,b,∗, Alessandro Thionea, María García-Garcíaa, Iván Heredia-Alcaldea, Alberto Pérez-Garcíaa, Alfonso Amador Valverde-Navarro a, María D Pérez-del-Caza a Department of Plastic Surgery and Burns, University and Polytechnic Hospital La Fe, Valencia, Spain b Department of Human Anatomy and Embryology, Universitat de València, Valencia, Spain a r t i c l e i n f o Article history: Received 5 July 2025 Accepted 31 August 2025 Available online 12 September 2025 Keywords: Latissimus dorsi ﬂap Reconstructive microsurgery Functional reconstruction Defect coverage Uses of latissimus dorsi ﬂap ∗ Corresponding author. a b s t r a c t The latissimus dorsi (LD) ﬂap deserves recognition as the “S.W.A.T.ﬂap” in reconstructive surgery, as a reﬂex of its unparalleled versatility and adaptability in addressing complex, high-risk reconstructive challenges. Much like the special intervention units we propose it to be named after, the LD ﬂap offers a wide range of strategies that allow us to tailor it to ﬁt virtually any defect in the human body, making it a cornerstone of reconstructive surgery. This ﬂexibility is supported by various features. The multiple dissection techniques and patient positioning options available enhance its utility in multi-disciplinary settings. Also, it can be harvested with different tissue compositions, such as muscle, skin, bone, and adipose tissue, providing surgeons with numerous conﬁgurations suited for diverse anatomical and functional needs. Moreover, the consistency of the thoracodorsal pedicle, allows for multiple vascular conﬁgurations and the creation of composite orchimeric ﬂaps, making it highly adaptable to complex defect reconstructions. Furthermore, the LD ﬂap is easily elevated with minimal E-mail address: [beanlor@alumni.uv.es](beanlor@alumni.uv.es) (B. Andresen-Lorca). [https://doi.org/10.1016/j.jpra.2025.08.037](https://doi.org/10.1016/j.jpra.2025.08.037) 2352-5878/© 2025 The Authors. Published by Elsevier Ltd on behalf of British Association of Plastic, Reconstructive and Aesthetic Surgeons. This is an open access article under the CC BY-NC-ND license ([http://creativecommons.org/licenses/by-nc-nd/4.0/](http://creativecommons.org/licenses/by-nc-nd/4.0/)) B. Andresen-Lorca, A. Thione, M. García-García et al. JPRAS Open 48 (2026) 269–280 donor-site morbidity, making it an attractive option for both functional and aesthetic restoration. To demonstrate the broad applications of the LD ﬂap, a systematic review following PRISMA guidelines was conducted. The review aimed to identify and synthesize reported cases of the ﬂap’suse across a variety of clinical scenarios, yielding articles detailing its use in diverse anatomical regions. This article highlights the LD ﬂap’s essential role in modern reconstructive surgery, advocating for its recognition as the “S.W.A.T.ﬂap” due to its exceptional versatility, reliability, and broad applicability. © 2025 The Authors. Published by Elsevier Ltd on behalf of British Association of Plastic, Reconstructive and Aesthetic Surgeons. This is an open access article under the CC BY-NC-ND license ([http://creativecommons.org/licenses/by-nc-nd/4.0/](http://creativecommons.org/licenses/by-nc-nd/4.0/)) Introduction The acronym S.W.A.T., which stands for “special weapons and tactics,” is used to design the U.S.’s special intervention units, speciﬁcally trained to resolve diﬃcult, high-risk situations.1 Reconstructive surgery could somehow be compared to working under these conditions, in the sense that we constantly encounter complex case

FAQs

Why is the latissimus dorsi flap called the “S.W.A.T. flap”?

It is proposed to be recognized as the “S.W.A.T. flap” because of its versatility and reliability when addressing complex, high-risk reconstructive situations.

What features increase the usefulness of the LD flap in practice?

The flap supports multiple dissection techniques and patient positioning options, can be harvested with different tissue compositions, and uses a consistent thoracodorsal pedicle that enables multiple vascular configurations.

How was the evidence on LD flap uses collected in this article?

A systematic review following PRISMA guidelines was conducted to identify and synthesize reported cases, describing its use across diverse anatomical regions.

Sep 28, 2026

Uploaded by Cipher