Comparison of morbidity of donor site following pedicled muscle-sparing latissimus dorsi flap versus extended latissimus dorsi flap breast reconstruction

The pedicled, descending-branch muscle-sparing latissimus dorsi (MSLD) flap has been widely used for breast reconstruction following total mastectomy. However, the superiority of the MSLD flap compared to the extended latissimus dorsi (ELD) flap has not yet been described. This study compares morbidities following pedicled MSLD flap and ELD flap breast reconstruction. A total of 36 women with pedicled MSLD flaps were compared with 37 women with ELD flap breast reconstruction. The medical records were reviewed for complications and demographic data. The authors compared morbidity including donor-site seroma, limitation of shoulder movement and aesthetic contour of the donor site following MSLD flap and ELD flap breast reconstruction. The authors compared the identified parameters and set the level of significance at the 0.05 alpha level. The demographic data of the two groups were not significantly different statistically. Donor-site seroma occurred in two MSLD patients (5.6%) and in 23 ELD patients (62.2%) (p = 0.0001). Limitation of shoulder movement occurred in nine MSLD patients (25%) and in 28 ELD patients (75.7%) (p = 0.0001). Back asymmetry occurred less frequently in the MSLD group (p = 0.0297). The pedicled, descending-branch MSLD flap, with its low complication rate and associated with minimal functional and aesthetic deficits of the donor site, can be a good option for breast reconstruction. Level of evidence: Therapeutic, III. (C) 2013 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.