Avoiding back wound dehiscence in extended latissimus dorsi flap reconstruction.

BACKGROUND: The latissimus dorsi breast reconstruction flap has a number of advantages, but despite the advances in surgical techniques, it has remained vulnerable to skin dehiscence or necrosis at the donor site. We describe a novel surgical technique to prevent this. METHODS: Patients treated with extended latissimus dorsi flap reconstruction between January 2005 and January 2010 were studied prospectively. RESULTS: Eighteen patients were reviewed (12 immediate and 6 delayed). Two patients were smokers. The mean age was 54.4 (range: 42-64) years and the mean body mass index was 31.6 (range: 22.3-38). The mean weight of the mastectomy specimen was 551 g (range: 280-980 g). Six patients developed back seroma which required aspiration, and one patient developed a haematoma of the reconstructed breast. All wounds healed primarily. CONCLUSION: The new technique is safe, simple and effective in avoiding wound dehiscence at the donor site after extended latissimus dorsi flap reconstruction.