Double Paddle “Kiss” Latissimus Dorsi Flap for Resurfacing Large Shoulder Defects

Reconstruction of large shoulder defects may not be possible with standard pedicled flap designs. Here, we describe a technique for coverage of a wide shoulder defect using the “Kiss” latissimus dorsi pedicled flap. This concept utilizes 2 or more skin paddles in series and combines these in parallel to permit coverage of a wider shoulder defect while permitting primary closure of the back donor site.