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The Utility and Success of Latissimus Flap Reconstruction
Subichin, Michael MD; Wagner, Douglas MD
Summa Health System
2014-03-16
Presenter: Michael Subichin, MD
Affidavit:
The above work entirely represents the original work of the resident. He participated in conception, data collection, analysis, and writing of the submission
Director Name: Douglas Wagner, MD
Author Category: Other Specialty Resident
Presentation Category: Clinical
Abstract Category: General Reconstruction
Purpose/Objective
The reconstructive use of the latissimus dorsi myocutaneous flap has been well substantiated. Latissimus reconstruction is a frequently used method of breast reconstruction. Additionally, latissimus flaps have been used for wound coverage, deformity correction, and as a salvage procedure for breast reconstruction when complicated by infection, radiation, or ischemia. We sought to determine the success of our latissimus dorsi flap use.
Methods
We performed a retrospective review of latissimus dorsi myocutaneous flaps by a single surgeon. 128 flaps from 117 patients were identified. We collected the indication, patient demographics and outcome. Means, incidences and success rates are reported.
Results
We identified 70 patients who had a latissimus breast reconstruction (62 unilateral and 8 bilateral), 37 patients who underwent a salvage procedure, 5 patients who required flap for wound coverage and 5 patients who required flap for lumpectomy deformity.
Mean age was 51 (SD 11.6) and 20 patients were active tobacco users. All flaps were viable (100%) and only one reconstruction failure (99% success rate) was identified. This occurred in a unilateral breast reconstruction patient because of an infected implant.
There were no failures among the 37 salvage patients (100% success) which included 8 tobacco users and 10 patients on active hormonal medications.
Conclusion
The latissimus flap is an effective and reliable method of reconstruction. It appears especially effective as a salvage tool in breast reconstruction, even in the setting of tobacco use. Early latissimus dorsi flap should be considered when reconstructive complications are present.
