Use of the free thoracodorsal artery perforator flap donor-site has safe outcomes and low morbidity rates, according to study results published in Plastic and Reconstructive Surgery.
The researchers performed a retrospective review of 293 patients whose defects were reconstructed with free thoracodorsal artery perforator flap between January 2002 and December 2014, including cases in which segmental latissimus dorsi muscle was harvested. The mean patient age was 43.4 years (range, 4-89 years).
Outcome measures included donor-site morbidity, including postoperative complications, scar-related problems, and functional impairment. Functional impairment was assessed using the Quick Disabilities of the Arm, Shoulder and Hand questionnaire with scores ranging from 0 (no disability) to 100 (maximal disability).
Donor-site complications developed in 33 patients (11.3%), which included dehiscence in 21 patients (7.2%) and seroma in nine patients (3.1%). Flap type significantly affected seroma development after adjusting for other factors.
Scar-related problems at the donor site occurred in 31 patients (10.6%), including 18 hypertrophic scars (6.1%) and 13 widened scars (4.4%). Hypertrophic scars occurred more often in nontransversely designed flaps than transversely designed scars (12.5% vs. 2.6%; P = .001). This difference was maintained in the multivariate analysis (OR 3.067; 95% CI, 0.852 to 11.041; P = .086).
A total of 110 patients within the most recent 5 years of the study responded to the functionality questionnaire. The median follow up period was 39 months (range, 8-68). The mean resulting score of the questionnaire was 2.68 (range, 0-18.2) and the majority of patients (90%) scored less than 10.
“Our results suggest that the thoracodorsal artery perforator flap donor site can be safe and provide very generous skin dimensions without leaving serious donor-site sequelae,” the researchers wrote. “Careful consideration of patient condition, thoughtful preoperative planning, and meticulous surgical procedure could reduce donor-site morbidity further.” – by Talitha Bennett
Disclosure: The researchers report no relevant financial disclosures.