Arch Aesthetic Plast Surg.  2018 Oct;24(3):99-104. 10.14730/aaps.2018.24.3.99.

Risk Factors of Donor Site Seroma Formation and Laboratory Analysis of Seromas after Breast Reconstruction with a Latissimus Dorsi Flap

• Lee S
• Jo T
• Son D

• KMID: 2437070
• DOI: http://doi.org/10.14730/aaps.2018.24.3.99

Abstract

BACKGROUND
Donor site seroma is the most frequent and troublesome complication of latissimus dorsi (LP) flaps. This study aimed to identify the risk factors of seroma formation after an LD flap and to evaluate the biochemical composition of seromas.
METHODS
The medical records of 84 patients who underwent an LD flap from September 2007 to May 2017 were reviewed. Age; body mass index (BMI); the type of breast surgery, reconstruction, and nodal dissection; the usage of fibrin glue; smoking; chemotherapy; and history of diabetes mellitus or hypertension were evaluated. In 11 of the 84 patients, the levels of electrolytes, glucose, proteins, lipids, and inflammatory markers present in seromas were investigated.
RESULTS
The overall incidence of seroma was 66.7%. Advanced age (≥45 years) and overweight (BMI ≥23 kg/m²) were significant risk factors for seroma. Patients who underwent an extended LD flap had a higher incidence of seroma than those who underwent a standard LD flap, while those who underwent breast-conserving surgery had a lower incidence of seroma than those who underwent other breast procedures. Lactate dehydrogenase (LDH) levels in seromas on postoperative day 2 demonstrated a positive linear correlation with the duration of drainage, but this relationship did not reach statistical significance.
CONCLUSIONS
Advanced age, overweight, wider excision or mastectomy, and use of an extended LD flap were found to be risk factors for seroma formation after breast reconstruction with an LD flap. It may be possible to infer whether a seroma will be long-lasting by measuring LDH levels in the seroma.

Keyword

Mammaplasty; Risk factors; Seroma; Surgical flaps

MeSH Terms

Body Mass Index
Breast*
Diabetes Mellitus
Drainage
Drug Therapy
Electrolytes
Female
Fibrin Tissue Adhesive
Glucose
Humans
Hypertension
Incidence
L-Lactate Dehydrogenase
Mammaplasty*
Mastectomy
Mastectomy, Segmental
Medical Records
Overweight
Risk Factors*
Seroma*
Smoke
Smoking
Superficial Back Muscles*
Surgical Flaps
Tissue Donors*
Electrolytes
Fibrin Tissue Adhesive
Glucose
L-Lactate Dehydrogenase
Smoke