The lateral thoracodorsal flap in breast reconstruction: A comparison between two plastic surgical centres

In a retrospective study the results of breast reconstruction with 146 late ral thoracodorsal flaps operated on during the period 1991-94 at the Depart ments of Plastic Surgery at the Sahlgrenska University Hospital in Goteborg and the Stockholm Slider Hospital were evaluated. The median age of the 13 5 patients was 51 years (range 37-74). About two thirds of the patients wer e also operated on on the opposite side at the same time; and this was done more often in Stockholm, which partly explains the longer operating time i n Stockholm. Perioperative bleeding (median 100 ml, range 25-400) was simil ar in both groups. Median postoperative bleeding, which was measured only i n Stockholm, was 300 ml (range 30-1000). Seromas were seen only in Goteborg where postoperative drains were rarely used. The rate of early complicatio ns (infection and partial necrosis) were higher in Stockholm where more fla ps were raised in irradiated tissue. We conclude that the results were simi lar in the two centres, and the thoracodorsal nap gives good results. The i ncidence of early morbidity could be reduced by excluding patients who had been irradiated, by inserting drains, and by giving antibiotic prophylaxis.