Preventing seroma in the latissimus dorsi flap donor site

A technique for preventing seroma in latissimus dorsi flap donor sites is presented. The procedure involves quilting the donor site skin flaps to the underlying tissues with absorbable sutures. In a single surgeon series, a retrospective group (n = 16) of non-quilted donor sites was compared to a prospective group of quilted donor sites (n = 11). The age range and indications for surgery were similar for each group. The incidence of donor site seroma was reduced from 56% to 0% after introduction of the new technique (P = 0.003). The mean volume of postoperative drainage was significantly less in the quilted group (320 ml vs. 608 ml; P < 0.05) and the drains were removed significantly earlier (mean 3.9 days vs. 7.3 days; P < 0.01). There was no significant difference in donor site drainage and time to drain removal between the non-quilted group that developed a seroma and those that did not. The procedure is easy to learn, straightforward to perform and requires no special instrumentation. We commend it to all surgeons who use latissimus dorsi flaps.