Subscribe to RSS
DOI: 10.5999/aps.2017.01683
The efficacy of elongated axillary incision on extended latissimus dorsi flap for immediate breast reconstruction
This work was supported by a clinical research grant from Pusan National University Yangsan Hospital 2016.
Background In performing extended latissimus dorsi (ELD) flap procedures, a skin paddle design on the bra line helps reduce visible scarring. This improves the patient’s satisfaction with the outcome. However, such a design leads to a longer operation time and increased fatigue of the surgeon due to the narrow operative field. In this study, the authors propose a method that elongates the axillary incision line posteriorly by 1.5 cm from the lateral border of the latissimus dorsi muscle. We examined whether this method could shorten the operation time and compared the incidence of complications between patients who underwent this novel procedure and patients who underwent the traditional procedure.
Methods In this study of patients who underwent ELD flap procedures for immediate breast reconstruction, 89 underwent surgery with the elongated axillary incision and 45 underwent surgery without the elongated incision. The total operation time and complications were retrospectively examined based on the patients’ medical records, and we examined whether there was any statistically significant difference in the total operation time.
Results In the experimental group with the elongated axillary incision, the operation time ranged from 125 to 255 minutes (median, 175 minutes). In contrast, in the control group without the elongated axillary incision, the operation time ranged from 142 and 340 minutes (median, 205 minutes). The operation time was statistically significantly different between the two groups, and no significant complications were observed in the experimental group.
Conclusions Elongation of the axillary incision alone may shorten the operation time of the ELD flap procedure without causing additional complications.
Publication History
Received: 14 November 2017
Accepted: 27 May 2018
Article published online:
03 April 2022
© 2018. The Korean Society of Plastic and Reconstructive Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonCommercial License, permitting unrestricted noncommercial use, distribution, and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes. (https://creativecommons.org/licenses/by-nc/4.0/)
Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA
-
REFERENCES
- 1 Heitmann C, Pelzer M, Kuentscher M. et al. The extended latissimus dorsi flap revisited. Plast Reconstr Surg 2003; 111: 1697-701
- 2 Lee JW, Chang TW. Extended latissimus dorsi musculocutaneous flap for breast reconstruction: experience in Oriental patients. Br J Plast Surg 1999; 52: 365-72
- 3 Hokin JA. Mastectomy reconstruction without a prosthetic implant. Plast Reconstr Surg 1983; 72: 810-18
- 4 Menke H, Erkens M, Olbrisch RR. Evolving concepts in breast reconstruction with latissimus dorsi flaps: results and follow-up of 121 consecutive patients. Ann Plast Surg 2001; 47: 107-14
- 5 McCraw JB, Papp C, Edwards A. et al. The autogenous latissimus breast reconstruction. Clin Plast Surg 1994; 21: 279-88
- 6 Papp C, McCraw JB. Autogenous latissimus breast reconstruction. Clin Plast Surg 1998; 25: 261-6
- 7 Germann G, Steinau HU. Breast reconstruction with the extended latissimus dorsi flap. Plast Reconstr Surg 1996; 97: 519-26
- 8 Chang DW, Youssef A, Cha S. et al. Autologous breast reconstruction with the extended latissimus dorsi flap. Plast Reconstr Surg 2002; 110: 751-9
- 9 Moore TS, Farrell LD. Latissimus dorsi myocutaneous flap for breast reconstruction: long-term results. Plast Reconstr Surg 1992; 89: 666-72
- 10 Maxwell GP. Latissimus dorsi breast reconstruction: an aesthetic assessment. Clin Plast Surg 1981; 8: 373-87