Long-Term Patient-Reported Donor-Site Complaints After Latissimus Dorsi Flap Reconstruction: A 20-Year Cohort

Latissimus dorsi (LD) flap harvest is widely used in reconstructive surgery, including head and neck reconstruction, but long-term patient-reported donor-site complaints remain insufficiently characterized. We retrospectively reviewed 90 patients who underwent free or pedicled LD myocutaneous flap reconstruction between 2004 and 2024. At long-term reassessment, patients were contacted and asked whether they currently experienced donor-site pain, dysesthesia, or subjective weakness. The median follow-up was 108 months. Pain was reported by 16 patients (17.8%), dysesthesia by 9 (10.0%), and subjective weakness by 2 (2.2%); 18 patients (20.0%) reported at least 1 complaint. Complaints were not significantly associated with sex, reconstructive indication, defect site, donor-site closure method, flap type, or laterality. Patients with pain or dysesthesia had significantly shorter follow-up than those without these complaints. The lower prevalence of pain and dysesthesia among patients with longer follow-up suggests that these donor-site complaints may diminish over time, providing a reassuring message for preoperative counseling.