J Korean Soc Plast Reconstr Surg.  2008 May;35(3):267-272.

Effect of Fibrin Sealant in Extended Lattisimus Dorsi Flap Donor Site: Retrospective Study

Affiliations
  • 1Department of Plastic and Reconstructive Surgery, Institute for Human Tissue Restoration, Yonsei University College of Medicine, Seoul, Korea. dhlew@yuhs.ac

Abstract

PURPOSE: Donor site seroma is the most common complication of extended latissimus dorsi flap for breast reconstruction. One of preventive treatments is to use the fibrin sealant in donor site before closure. Experimentally, it has been used successfully in the prevention of latissimus donor site seroma, but its clinical efficacy and results were very controversial. Thus, the purpose of this study is to evaluate the clinical efficacy and to determine the optimal dose of fibrin sealant.
METHODS
A retrospective study was done of patients operated under same surgical conditions by one operator with variable doses of fibrin sealant. The study group consisted of 60 consecutive patients who underwent breast reconstruction with extended latissimus flap reconstructions from January 2005 to December 2006. Patients were divided into 4 group by applied fibrin sealant amount(group 1=0mL, group 2=1mL, group 3=2mL, group 4=4mL). Retrospective data were obtained from total postoperative drainage amount, time from surgery to drain removal, and incidence and quantity of seroma formation in matched patients group.
RESULTS
Total drainage amount decreased relative to the amount of fibrin sealant. The seroma formation rate of 30% in the study group 4 was significantly less than group 1 rate of 71%(p<0.05). It was an improvement over the rates of as much as 79% described previously in the literature. Also, time from surgery to drain removal was shortened significantly in group 4 patients (p<0.05).
CONCLUSION
The use of fibrin sealant in the extended latissimus dorsi flap donor site appears effective in preventing seroma. However, important factors to obtain lower seroma formation rates are proper techniques and proper amounts such as the authors suggested amount: 0.01mL/cm2 with spray type fibrin sealant.

Keyword

Latissimus dorsi flap donor site; Fibrin sealant; Tissel VH(R); Tissucol(R); Breast reconstruction; Extended latissimus dorsi flap

MeSH Terms

Drainage
Female
Fibrin
Fibrin Tissue Adhesive
Humans
Incidence
Mammaplasty
Retrospective Studies
Seroma
Tissue Donors
Fibrin
Fibrin Tissue Adhesive
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