The extended latissimus dorsi flap option in autologous breast reconstruction: A report of 14 cases and review of the literature

Abstract

Background: Autologous breast reconstruction using the extended latissimus dorsi flap has been infrequently reported. in the current study, the authors are reporting their own clinical experience with this method. a review of the literature is also discussed.Materials and methods: Over a three year period, 14 patients underwent breast reconstruction using the extended latissimus dorsi (ld) flap. patients with small to medium sized breasts were selected. the age of the patients ranged from 29 to 42 years with a follow-up period ranging from six to 18 months. the indications, flap-related complications and donor site morbidity and aesthetic results were evaluated.Results: The main indication to use the flap was dorsal donor site preference by patients. the remaining patients were either not suitable for a flap from the abdomen or wished to get pregnant and were offered the dorsal donor site. neither total nor partial flap loss was recorded but donor site morbidity was mainly due to seroma, which was treated conservatively in all patients, except for one who required surgery. another two patients suffered from wound breakdown and distal necrosis of the back flaps. mild contour deformity was also noted on the back of all patients but caused no major concern. indeed, the overall patient satisfaction was very high.Conclusion: The extended ld flap proved to be a good option for autologous breast reconstruction in selected patients. patients should be warned of the potential for seroma and mild contour back deformity.

The musculoskeletal consequences of breast reconstruction using the latissimus dorsi muscle for women following mastectomy for breast cancer: A critical review

“…An observational study conducted by Rifaat et al (2008) prospectively evaluated the efficacy of the extended LD flap as an option in autologous breast reconstruction (n = 14). Pre-operative assessment included physical examination with the follow-up period ranging from 6 to 18 months.…”

“…Treatment for breast cancer often includes mastectomy, and breast reconstruction is considered an important management option (Ditsch et al 2013;Rifaat, Amin, Bassiouny, Nabawi, & Monib, 2008;Spector, Mayer, Knafi, & Pusic, 2011). The UK National Institute for Health and Clinical Excellence (NICE) recommends that reconstruction should be available to all women with breast cancer at the initial surgery (Winters et al, 2012).…”

Thoracodorsal artery flaps for breast reconstruction–the variants and its approach

“…The ELD flap and the conventional LD flap are raised in the same manner, but the extended version contains a maximum amount of subcutaneous soft tissue on top of the LD muscle [20][21][22]. The ELD flap is illustrated in Fig.…”

“…Some patients opt for LD reconstruction rather than a perforator flap. In women who actively engage in sports, we aim to leave the muscle function intact and advise the use of perforatorbased flaps due to the risk of shoulder and arm-related morbidity following LD flap harvest [15,20].…”

“…The ELD flap can be indicated/selected in women with a high body mass index (BMI) and localized fat deposits in the back [20] where other reconstructive options are less favorable [21]. Harvest of the flap does, however, come with a risk of donor site seroma.…”