The Effectiveness of Progressive Tension Suture at Latissimus Dorsi Muscle Harvest.

Moon, Joo Bong; Park, Jung Min; Kwon, Yong Seok; Lee, Keun Cheol; Kim, Seok Kwun; Cho, Se Heon

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Original Article

Journal of the Korean Society of Plastic and Reconstructive Surgeons 2007;34(5):611-616.
Published online September 1, 2007.

The Effectiveness of Progressive Tension Suture at Latissimus Dorsi Muscle Harvest.

Joo Bong Moon, Jung Min Park, Yong Seok Kwon, Keun Cheol Lee, Seok Kwun Kim, Se Heon Cho

¹Department of Plastic and Reconstructive Surgery-Breast Center, College of Medicine, Dong-A University, Busan, Korea. sgkim1@daunet.donga.ac.kr
²Department of General Surgery-Breast Center, College of Medicine, Dong-A University, Busan, Korea.
³W Plastic Clinic, Busan, Korea.

Abstract

PURPOSE
The latissimus dorsi muscle flap is a versatile flap used in a variety of reconstructive procedures. The most common complication of LD muscle flap is donor site seroma, reported to occur in 20 to 79 percent of cases. The formation of dead space under the flap is intimately associated with seroma formation. The authors think that the use of progressive tension suture at closing donor site can decrease the formation of dead space and ultimately reduce the incidence of donor site seroma. METHODS: A retrospective review was performed with 38 patients who underwent latissimus dorsi muscle harvest for breast reconstruction from March 2003 to September 2004. Progressive tension sutures were used during donor site closure in 22 patients. This group was compared with controls group(16 patients) who underwent latissimus dorsi muscle harvest without using this technique. Operation time, length of hospital stay, period of drainage, complication, and satisfaction about postoperative scar of donor site were examined.
RESULTS
The average length of hospital stay was 10.2 days and 12.7 days, and the mean duration of drainage were 7.3 days and 11.7 days in each progressive suture group and control group. These results were statistically significant (p<0.05). In the 22 patients who underwent progressive tension suture, none had seroma, hematoma or skin necrosis. In control group(16 patients), there happened one seroma formation and one partial skin necrosis. These complications were healed by aspiration of seroma and wound revision. The patients' satisfaction was not statistically significant, but the higher points were given by the patients who underwent progressive tension suture.
CONCLUSION
This technique, progressive tension suture, is an effective method to reduce or eliminate donor site seroma, which is the most common complication associated with latissimus dorsi muscle harvest.

Keywords: Progressive tension suture; Seroma; Latissimus dorsi muscle

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