COMPLICATIONS OF LATISSIMUS-DORSI MYOCUTANEOUS FLAP BREAST RECONSTRUCTION

Aims. To review the experience of a single unit in post-mastectomy rec onstruction using the latissimus dorsi flap. Method. A retrospective r eview of 111 cases treated between 1984 and 1993. The notes were evalu ated for type of procedure, associated treatment and complications. Re sults. A significant morbidity of this procedure was demonstrated with 41 (37%) patients requiring a second operation during the period of t he study. The majority of these second operations were related to the prosthesis used to achieve symmetry. Second operations were more commo n in those who had saline-filled prostheses. Other complications seen included wound infection, small areas of flap necrosis, hypertrophic s cars and problems with the donor scar. No differences in complication rates were demonstrated for delayed vs immediate procedures or for pat ients receiving or not receiving radiotherapy. No life-threatening com plications were seen during the study. Conclusions. The latissimus dor si reconstruction is reliable but the overall programme is beset with considerable morbidity. This factor needs to be taken into considerati on when discussing reconstructive options with the postmastectomy pati ent.