Analysis of donor site complications after latissimus dorsi flap transplantation with different closure methods
Objective To analyze the postoperative complications of latissimus dorsi myocutaneous flap with different donor site closure methods.Methods Retrospective analysis from June 2017 to June 2020,52 patients with latissimus dorsi myocutaneous flap were treated in Department of Hand Surgery,Suzhou Ruihua Orthopaedic Hospital.Including free latissimus dorsi myocutaneous flap in 30 cas-es,pedicled latissimus dorsi myocutaneous flap in 22 cases,wound repair in 43 cases and limb function reconstruction in 9 cases.The flap area was 10 cm×4 cm～43 cm×15 cm and the operation time was 2.0～10.5 h.Direct suture was performed in 36 cases and skin grafting in 16 cases.According to the closing mode of the donor area,the patients were divided into direct suture group and skin grafting group,and the complications of the two groups were compared.Results All patients were followed up for 6 to 38 months.the complications in the direct suture group were hematoma in 2 cases,infection in 1 case,partial incision dehiscence in 2 cases,centipede hyperplastic scar in 13 cases,scar contracture in 1 case.The complications in the skin grafting group were hematoma in 4 cases,skin graft necrosis in 4 cases,centipede foot hyperplasia in 5 cases,muscle scar in 7 cases,scar contracture in 1 cases,shoulder dysfunction in 1 cases and depressed deformity in 3 cases.There was no significant difference in the incidence of hematoma,infection,wound laceration and dyskinesia among the complications of different donor site closure methods(P＞0.05).The incidence of abnormal scar and sunken deformity in the suture group was lower than that in the skin graft group(P＜0.05).The difference was statistically significant(P＜0.05).Conclusion The compli-cations can be effectively prevented by reducing incision tension and cosmetic suture.Reducing unnecessary skin grafting can effectively prevent the occurrence of complications.
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