Experience with Extended LAD Flap for Autologous Breast Reconstruction

Aim: To evaluate the clinical outcome of extended Latissimus dorsi flap for autologous breast reconstruction at our Institution. Our study included 32 patients who were presented at Jinnah Burn Centre/ Jinnah Hospital, Lahore during last 3 years from Jan2014 to Jan 2017. Methods: Over a three years period, thirty-two patients underwent patients underwent breast reconstruction using the extended latissimus dorsi flap. Patients with small to moderate sized breasts were selected. In twenty-eight patients single stage reconstructing, after skin sparing mastectomy with or without axillary clearance, was carried out. Four patients presented for delayed reconstruction. Patient age ranged from 19-45Yrs with average age 32.8 Yrs. Results: All of the flaps survived in thirty-two patients. We have not observed partial or total flap loss in our patients. One flap pedicle was cauterised during axillary clearance and that flap was salvaged by resection of involved part of the artery and microvascular anastomosis. The same patient developed fat necrosis too. Donor site complication included seroma formation in two patients which was managed conservatively by repeated aspiration and compression bandage. Hypertrophy of the donor site scar in one patient, hypertrophic scarring of the medial margin of recipient site scar in another patient. Contour deformity of the back was noted in all patients but was not an issue as was not visible by the patient. Conclusion: Our preliminary experience reconfirms total autologous reconstruction with ELD flaps and is ideal for small and medium sized breasts.