Efficacy of Quilting Sutures and Fibrin Sealant Together for Prevention of Seroma in Extended Latissimus Dorsi Flap Donor Sites

Background The extended latissimus dorsi flap is important for breast reconstruction.Unfortunately, donor site seroma is the most common complication of extended latissimusdorsi flap for breast reconstruction. Although using fibrin sealant in the donor site reducesthe rate of seroma formation, donor site seroma remains a troublesome complication. Thepurpose of this study was to analyze the effectiveness of the combination of quilting suturesand fibrin sealant in the latissimus dorsi donor site for the prevention of seroma.Methods Forty-six patients who underwent breast reconstruction with extended latissimusflap were enrolled in the study. The patients received either fibrin sealant (group 1, n=25) or acombination of fibrin sealant and quilting sutures (group 2, n=21) in the extended latissimusdorsi donor site. Outcome measures were obtained from the incidence, volume of postoperativeseroma, total drainage amount, indwelling period of drainage, and duration of hospital stay.Results The incidence of seroma was 76% in group 1 and 42.9% in group 2 (P=0.022). We alsofound significant reductions in seroma volume (P=0.043), total drainage amount (P=0.002),indwelling period of drainage (P=0.01), and frequency of aspiration (P=0.043). The quiltingsutures did not affect the rate of drainage, tube reinsertion, or hospital stay.Conclusions The use of quilting sutures combined with fibrin sealant on the latissimus dorsiflap donor site is helpful for reducing the overall seroma volume, frequency of aspiration, andtotal drainage amount.