RESUMEN
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.
Asunto(s)
Femenino , Humanos , Aspiraciones Psicológicas , Vendajes , Estudios de Cohortes , Drenaje , Incidencia , Mamoplastia , Terapia de Presión Negativa para Heridas , Complicaciones Posoperatorias , Estudios Prospectivos , Seroma , Músculos Superficiales de la Espalda , Colgajos Quirúrgicos , Donantes de Tejidos , Heridas y LesionesRESUMEN
Repairing of complex abdominal wall defects challenges both general and reconstructive surgeons. For the large-full-thickness defects, distant flaps or free tissue transfer is required to restore the abdominal wall. In this report, a patient with large abdominal defect following excision of a large peripheral nerve sheath tumor was reconstructed by free latissimus dorsi flap. The reconstruction was successful although revascularization was performed one day later. The patient recovered well with no abdominal wall weakening after 4-month follow-up.
RESUMEN
Complex abdominal wall defects may result from trauma, extensive infections or resection of primary or secondary tumors. The reconstructive goals are to protect abdominal contents and provide functional support. This challenge both general and reconstructive surgeons. Various abdominal reconstruction techniques are reviewed and summarized to clarify the treatment options for each particular defect.