Total quilting suture at latissimus dorsi muscle donor site: Drain tube is no longer needed

Abstract

Latissimus dorsi myocutaneous flap (LDMCF) is one of the most frequently used autologous tissue flaps for breast reconstruction after partial or total mastectomy in patients with breast cancer. The most common postoperative complication in reconstructive surgery using LDMCF is seroma formation at the donor site. The incidence of seroma formation at the LDMCF donor site has been reported as high as approximately 70% to 80% [1-3]. Postoperatively, a seroma can cause patient discomfort and a longer period for maintaining the drain tube, which can lead to longer hospitalization. In addition, frequent needle aspiration of a seroma or outpatient visit may be required. A seroma can be a substantial cause of a patient’s discomfort, anxiety, infection, wound dehiscence, and consequently, flap necrosis, and scarring [4,5]. Consequently, postoperative adjuvant therapy including chemotherapy and radiation therapy may be delayed. Several studies have shown that use of the quilting suture technique at the LDMCF donor site helps reduce seroma formation and further complications after breast reconstruction surgery [6-12]. However, there has been no previous study about the effect regarding the extent of quilting suture at the LDMCF donor site. We investigated the degree of seroma formation and the need for a drainage tube according to the extent of quilting suturing at the LDMCF donor site.