The Role of Negative-Pressure Wound Therapy in Latissimus Dorsi Flap Donor Site Seroma Prevention: A Cohort Study.

Authors:
Apichai Angspatt
Apichai Angspatt
Chulalongkorn University
Thailand
Thana Laopiyasakul
Thana Laopiyasakul
Chulalongkorn University
Pornthep Pungrasmi
Pornthep Pungrasmi
Chulalongkorn University
Poonpissamai Suwajo
Poonpissamai Suwajo
King Chulalongkorn Memorial Hospital

Arch Plast Surg 2017 Jul 15;44(4):308-312. Epub 2017 Jul 15.

Division of Plastic and Reconstructive Surgery, Department of Surgery, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.

Background: Donor site seroma is the most common complication after latissimus dorsi (LD) flap harvest. This study aimed to evaluate the efficacy of negative-pressure wound therapy (NPWT) in preventing donor site seroma formation after the harvest of an LD flap for breast reconstruction.

Methods: In this prospective matched-pair study, 40 patients in whom an LD flap was harvested for breast reconstruction were enrolled. NPWT was used in 20 patients, and in a control group composed of another 20 patients, the conventional donor site dressing technique was used. Information was collected regarding postoperative complications, the incidence of seroma, total drainage volume, the number of percutaneous seroma aspirations, and the volume aspirated.

Results: In the NPWT group, the incidence of seroma formation after drain removal was significantly lower than in the control group (15% vs. 70%; odds ratio=0.07; relative risk, 0.24). Both the mean percutaneous aspirated volume (P=0.004) and the number of percutaneous aspirations (P=0.001) were also significantly lower in the NPWT group. There were no significant differences in the total drainage volume or the duration of wound drainage between the NPWT dressing group and the control group (P>0.05).

Conclusions: This study showed that NPWT is a promising tool for reducing the incidence of seroma formation after removing the drain at the donor site after LD flap harvesting. It is a simple and safe technique.

Download full-text PDF

Source
http://dx.doi.org/10.5999/aps.2017.44.4.308DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5533065PMC
July 2017
6 Reads

Publication Analysis

Top Keywords

donor site
20
site seroma
12
incidence seroma
12
control group
12
seroma formation
12
npwt group
8
dorsi flap
8
latissimus dorsi
8
drainage volume
8
negative-pressure wound
8
number percutaneous
8
total drainage
8
wound therapy
8
seroma
7
npwt
6
group
6
site
5
flap
5
donor
5
removal lower
4

Similar Publications

The drain game: back drains for latissimus dorsi breast reconstruction.

J Plast Reconstr Aesthet Surg 2014 Feb 26;67(2):226-30. Epub 2013 Oct 26.

Plastic & Reconstructive Surgery Department, Royal Free London NHS Foundation Trust, Royal Free Hospital, London NW3 2QG, UK.

Introduction: The pedicled latissimus dorsi myocutaneous (LD) flap is a popular breast reconstruction choice, representing approximately 50% of procedures undertaken in the UK. Donor site drain use may reduce complication rates, however no evidence exists regarding the duration of back drain use for LD flap breast reconstruction and calls have been made in the literature to investigate this further.

Aim: To compare inpatient hospital stay, drainage parameters and donor-site complications associated with closed suction back drain removal by post-operative day (POD) 3 regardless of output (early group), with removal after POD 3 where instructions were documented by drainage volume/24 h ± output consistency (late group), in post-mastectomy LD reconstruction donor sites. Read More

View Article
February 2014

Comparison of Donor Site Drainage Duration and Seroma Rate Between Latissimus Dorsi Musculocutaneous Flaps and Thoracodorsal Artery Perforator Flaps.

Ann Plast Surg 2017 Aug;79(2):183-185

From the *Division of Plastic and Reconstructive Surgery, National Cancer Center Hospital, Tokyo, Japan; and †Division of Plastic and Reconstructive Surgery, National Cancer Center Hospital East, Kashiwa, Japan.

Introduction: Donor site seroma formation and prolonged drainage duration are common complications of using latissimus dorsi musculocutaneous (LDMC) flaps. The present retrospective study aimed to investigate the effect of types of back flap harvest on drainage duration and seroma formation rates.

Methods: Adult patients (n = 155) who underwent reconstruction with a latissimus dorsi flap from January 2010 to October 2015 were included in the study, of which 54 patients underwent breast reconstruction with a pedicled LDMC flap (LD breast group), 80 patients underwent an LDMC flap transfer for purposes other than breast reconstruction (LD nonbreast group), and 21 patients underwent soft tissue reconstruction with a thoracodorsal artery perforator (TAP) flap (TAP group). Read More

View Article
August 2017

The use of OK-432 to prevent seroma in extended latissimus dorsi flap donor site after breast reconstruction.

J Surg Res 2015 Jan 12;193(1):492-6. Epub 2014 Aug 12.

Department of Surgical Oncology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, People's Republic of China. Electronic address:

Background: The extended latissimus dorsi (LD) flap has become a preferred method of breast reconstruction. However, donor site seroma is the most common complication of LD flap reconstruction. The purpose of this study was to investigate the effectiveness of OK-432 on postoperative drainage and seroma formation in the site of the LD myocutaneous flap donor site. Read More

View Article
January 2015

Efficacy of quilting sutures and fibrin sealant together for prevention of seroma in extended latissimus dorsi flap donor sites.

Arch Plast Surg 2012 Sep 12;39(5):509-13. Epub 2012 Sep 12.

Institute for Human Tissue Restoration, Department of Plastic and Reconstructive Surgery, Yonsei University College of Medicine, Seoul, Korea.

Background: The extended latissimus dorsi flap is important for breast reconstruction. Unfortunately, donor site seroma is the most common complication of extended latissimus dorsi flap for breast reconstruction. Although using fibrin sealant in the donor site reduces the rate of seroma formation, donor site seroma remains a troublesome complication. Read More

View Article
September 2012