Arch Plast Surg.  2012 Sep;39(5):509-513. 10.5999/aps.2012.39.5.509.

Efficacy of Quilting Sutures and Fibrin Sealant Together for Prevention of Seroma in Extended Latissimus Dorsi Flap Donor Sites

• Shin IS
• Lee DW
• Lew DH

• KMID: 2267715
• DOI: http://doi.org/10.5999/aps.2012.39.5.509

Abstract

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. The purpose of this study was to analyze the effectiveness of the combination of quilting sutures and fibrin sealant in the latissimus dorsi donor site for the prevention of seroma.
METHODS
Forty-six patients who underwent breast reconstruction with extended latissimus flap were enrolled in the study. The patients received either fibrin sealant (group 1, n=25) or a combination of fibrin sealant and quilting sutures (group 2, n=21) in the extended latissimus dorsi donor site. Outcome measures were obtained from the incidence, volume of postoperative seroma, total drainage amount, indwelling period of drainage, and duration of hospital stay.
RESULTS
The incidence of seroma was 76% in group 1 and 42.9% in group 2 (P=0.022). We also found significant reductions in seroma volume (P=0.043), total drainage amount (P=0.002), indwelling period of drainage (P=0.01), and frequency of aspiration (P=0.043). The quilting sutures did not affect the rate of drainage, tube reinsertion, or hospital stay.
CONCLUSIONS
The use of quilting sutures combined with fibrin sealant on the latissimus dorsi flap donor site is helpful for reducing the overall seroma volume, frequency of aspiration, and total drainage amount.

Keyword

Mammaplasty; Surgical flaps; Seroma; Suture techniques

MeSH Terms

Drainage
Female
Fibrin
Fibrin Tissue Adhesive
Humans
Incidence
Mammaplasty
Outcome Assessment (Health Care)
Seroma
Surgical Flaps
Suture Techniques
Sutures
Tissue Donors
Fibrin
Fibrin Tissue Adhesive