Progressive tension sutures to prevent seroma formation after latissimus dorsi harvest

The latissimus dorsi muscle flap is a versatile flap used in a variety of reconstructive procedures. The major complication reported with its use is donor-site seroma, reported to occur in 20 to 79 percent of cases. A retrospective review of 47 patients undergoing latissimus dorsi muscle harvest from April of 1998 through May of 2002 was performed. Progressive tension sutures were used during donor-site closure in 22 patients from March of 2000 through May of 2002. This group was compared with historical controls from April of 1998 through March of 2000 (n = 23) who underwent latissimus dorsi harvest without use of the technique. Seven of 23 controls (30 percent) developed seromas at the donor site, compared with 0 of 22 (Fisher's exact text, p = 0.0092). The authors conclude that use of progressive tension sutures placed at the time of donor-site closure is an effective method to reduce or eliminate the most common complication associated with latissimus dorsi harvest. Technique recommendations are reviewed.