Chronic Expanding Hematoma on Latissimus Dorsi Free Flap Donor Site Grown Over 17 Years

Abstract

performed in multiple sessions would also have been eliminated in 2 cases. Most of the frozen biopsies (80%) were performed in cases without a specific pathology. However, planning the treatment according to our diagnostic algorithm would have resulted in a frozen biopsy recommendation in only 1 (12.5%) case without a specific pathology, whereas a frozen biopsy would have been performed in all cases with a specific pathology. Besides, there would have been no decrease in the detection of specific cases and the procedures finally deemed to be necessary, despite the decrease in the investigations and procedures performed in cases without a specific pathology. On the other hand, it should be noted that 2 of our cases (vasculitis and lymphangioma) did not have any preoperative or intraoperative specific findings and it was not possible to detect them without a routine biopsy (Supplementary Digital Content, Table 5, http://links.lww.com/SCS/D119).The limitations of the study include its retrospective nature and the relatively low number of cases with a specific pathology. However, we believe that the detailed records of the entire process in all the cases with a suspicion of a specific pathology at our clinic decreases the limitations due to the retrospective nature. On the other hand, it may be difficult for many centers to gather a sufficient number of cases since specific pathologies of the LS are rare.In conclusion, we believe that our diagnostic algorithm could increase the chance of diagnosing specific pathologies of the LS, which are rare, and could help avoid unnecessary investigations in cases without a specific pathology. However, more studies, and especially prospective ones, need to be conducted at different centers for the evaluation and further development of this algorithm, which was presented as the first of its kind.

Free Flap Donor-Site Complications and Management

“…Several authors have described hematoma formation 12 months following the initial surgery. 31 Shear stress between the subcutaneous fat and fascia of the donor site has been proposed as a mechanism. 32…”

“…Several authors have described hematoma formation 12 months following the initial surgery. 31 Shear stress between the subcutaneous fat and fascia of the donor site has been proposed as a mechanism. 32 Rectus Abdominis (Vertical Rectus, Transverse Rectus, and/or DIEP Perforator Flap) Donor-Site Complications…”