Postoperative Seroma Formation in Breast Reconstruction With Latissimus Dorsi Flaps

Abstract

The latissimus dorsi flap has been widely used in breast reconstruction surgery. Despite its potential advantages such as low donor morbidity and vascular reliability, the complication of donor-site seroma formation frequently occurs. Consecutive 174 patients who underwent breast reconstruction with the latissimus dorsi flap from 2001 to 2006 were retrospectively reviewed. The age, body mass index (BMI), smoking history, timing of reconstruction, type of breast surgery and nodal dissection, and several other intraoperative data were analyzed. The overall incidence of postoperative seroma was 21%. Increased age (>50 years) and obesity (BMI >23 kg/m) were significant risk factors for seroma formation (P = 0.02 and 0.004, respectively). The patients who underwent skin-sparing mastectomy or modified radical mastectomy had higher incidence of seroma formation (28% and 33%, respectively) as compared with those who had breast-conservative surgery (11%). A significant correlation was found between the type of breast surgery and the incidence of seroma (P = 0.04). The type of nodal dissection did not affect the incidence of postoperative seroma (P = 0.66). We concluded that increased age, obesity, and invasive breast surgery are risk factors for donor-site seroma formation after breast reconstruction with the latissimus dorsi flap. Close attention should be paid to prevent development of postoperative seroma when operating on such high-risk patients.

Risk Factors for Donor-Site Seroma Formation After Immediate Breast Reconstruction With the Extended Latissimus Dorsi Flap

“…Tomita et al reported that the overall incidence of postoperative seroma was 21%, and they suggested that increased age, obesity, and invasive breast surgery are risk factors for postoperative donor-site seroma with LD flap. 11 These results were very similar to ours.…”

“…20 There were several reports of association between seroma and smoking history, but no direct association was found between them. 11,12 More large-scale and long-term follow-up studies are required to evaluate this in detail.…”

Freier Latissimus-dorsi-Transfer zur Rekonstruktion von Weichteildefekten der unteren Extremität

“…Serome im Bereich der Latissimusdorsi-Hebestelle sind keine seltene Komplikation [9,34]. Beim Heben eines "extended" M. latissimus dorsi mit größe-rem Fettanteil sind in einer Kohortenstudie mit 43 Patientinnen in 72% der Fäl-le postoperative Serome berichtet worden [9].…”

“…Beim Heben eines "extended" M. latissimus dorsi mit größe-rem Fettanteil sind in einer Kohortenstudie mit 43 Patientinnen in 72% der Fäl-le postoperative Serome berichtet worden [9]. Bei konventioneller Hebung des M. latissimus dorsi liegt die Rate in einer Kohortenstudie mit 174 Patientinnen bei 21% [34].…”

Will a Fibrin Sealant be Effective as a Seroma Reductant and a Hemostatic Agent in Breast Reconstruction Using a Latissimus Dorsi Flap?

“…The most common complication is seroma formation, and the incidence of seroma as a complication has been reported to vary, ranging from 1% to 56% [2,3]. Despite such a high incidence, only limited research on donor-site seroma formation has been conducted [4,5].…”