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

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 or chimeric flaps, making it highly adaptable to complex defect reconstructions. Furthermore, the LD flap is easily elevated with minimal 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's use 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.