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Preventing Seroma in the Latissimus Dorsi Flap Donor Site With Fibrin Sealant

Weinrach, Jonathan C. MD; Cronin, Ernest D. MD; Smith, Bruce K. MD; Collins, Donald R. Jr MD; Cohen, Benjamin E. MD

doi: 10.1097/01.sap.0000112286.30212.12
Original Article
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Donor site seroma continues to be the most common complication of latissimus dorsi flap reconstruction. Numerous preventive methods and treatments have been described. The use of fibrin sealant in the donor site before closure may be an effective means of seroma prevention. The authors evaluated the efficacy of fibrin sealant in conjunction with closed suction drainage in a series of 17 latissimus flap donor sites. They also determined their approximate institutional seroma rate with a retrospective chart review of 20 donor sites. The fibrin sealant patients had a seroma rate of 11.8% compared with a rate of 35% among the untreated patients (P = 0.047). This compares favorably with seroma rates as high as 79% described in the literature. In conclusion, the use of fibrin sealant in the latissimus flap donor site appears to be effective in preventing seroma.

In a comparison study of 37 latissimus flap reconstructions, the seroma rate was reduced from 35% to 11.8% by the direct application of 5 cc of reconstituted fibrin sealant to the donor site surfaces prior to closure.

From the CHRISTUS St. Joseph Hospital, Plastic Surgery Residency Program, Houston, TX.

Received September 25, 2003. Accepted for publication November 6, 2003.

Reprints: Jonathan C. Weinrach, MD, CHRISTUS St. Joseph Hospital, Plastic Surgery Residency Program, 1315 St. Joseph Parkway, Suite 920, Houston, TX 77002. E-mail: jonweinrach@hotmail.com

© 2004 Lippincott Williams & Wilkins, Inc.