Large Axillary Defect after Lymph Node Dissection Directly Closed by Suturing the Pectoralis Major to the Latissimus Dorsi

SUMMARY: In 2009, the Union for International Cancer Control defined lymph node (LN) metastasis ≥6 cm in diameter as stage 4 in squamous cell carcinoma of the skin. Lesions from such LNs become ulcerated and infected and bleed without treatment. A 67-year-old man suffered from skin cancer on his right back and a 7-cm-diameter LN metastasis. After axillary LN dissection, a large skin and soft tissue defect was apparent. To rectify the defect, we simply sutured the pectoralis major muscle to the latissimus dorsi muscle and covered the suture with a split-skin mesh graft. After the surgery, the range of motion of the upper limb on the side where surgery was performed remained in good condition.