Refractory Donor-Site Seroma Following DIEP Breast Reconstruction

Donor-site seroma formation is a complication of autologous breast reconstruction reported most commonly with the use of latissimus dorsi flaps. First-line treatment is percutaneous aspiration which leads to resolution in the majority of cases. Those that persist may progress to a chronic, refractory seroma, which can prove challenging in terms of treatment. The aim of this article is to provide an updated literature review of interventions for chronic donor-site seroma and present the case of a 65-year-old female with a recalcitrant abdominal seroma following deep inferior epigastric perforator (DIEP) flap breast reconstruction. Literature review revealed a single article that reported 2 cases of persistent donor-site seroma after DIEP flap breast reconstruction. The patient presented here underwent repeat aspiration, drain placement, and multiple surgical procedures to achieve resolution. In total, the post-reconstruction seroma history of the patient extended over approximately 14 months. We conclude with evidence-based suggestions for chronic, donor-site seroma prevention and treatment.

Neurotized latissimus dorsi flap: functional lower limb coverage in subacute trauma reconstruction

In the reconstruction of the mangled lower extremity, muscle flaps are well known for their reliable use in soft tissue coverage, however very few reports document their functional reconstruction potential as neurotized muscle flaps. This case illustrates that free neurotized latissimus dorsi flaps are a good option for long-term functional reconstruction in the mangled lower extremity. Our report is the first case in the literature to date describing a subacute reconstruction with a functional latissimus dorsi in lower extremity trauma.