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

Abstract

The type of back flap harvest used significantly affected drainage duration and seroma formation rate in the present study. Lumbar fat extension with the use of a LDMC flap for breast reconstruction may lead to seroma formation. Thoracodorsal artery perforator flaps are associated with minimal risks of seroma formation and significantly shortened drainage duration compared with LDMC flaps.

Clinical Applications of the Thoracodorsal Artery Perforator Flap in Extremity Soft Tissue Reconstruction

“…The sacrifice of the muscle together with the lumbar fat used in extended flaps are the main causes of post-operative seroma formed after LD myocutaneous flaps [17]. The TDAP flap was reported to preserve LD muscle reducing the postoperative drainage and risk of seroma formation [14,17,18,21]. This correlates with our study (only 1 case of post-operative seroma, 5%).…”

“…Seroma formation may increase the risk of wound dehiscence and secondary infection requiring serial needle aspirations. The sacrifice of the muscle together with the lumbar fat used in extended flaps are the main causes of post-operative seroma formed after LD myocutaneous flaps [17]. The TDAP flap was reported to preserve LD muscle reducing the postoperative drainage and risk of seroma formation [14,17,18,21].…”

Propeller TAP flap breast reconstruction: A simplified surgical technique

“…M A N U S C R I P T 2 The latissimus dorsi (LD) myocutaneous flap is a valid option for breast reconstruction although there are some drawbacks to its use due to donor site seroma formation and potential affection of the shoulder and arm function 1,2 . The muscle sparing LD flap and thoracodorsal artery perforator (TAP) flap have been proposed as alternatives associated with less donorsite morbidity, but has not gained general acceptance yet 1,3 .…”

Three-dimensional visualization of thoracodorsal artery perforators using photoacoustic imaging✰,✰✰

“…[3][4][5] Low donor site morbidity is an advantage of the TDAP flap, characterized by the preservation of both the latissimus dorsi (LD) muscle and thoracodorsal nerve; a low incidence of seroma is another advantage. 6 TDAPs originate from the descending branch of the thoracodorsal artery, which travels along the lateral edge of the LD. The most proximal perforator is called the first perforator.…”