The role of the lateral thoracodorsal fasciocutaneous flap in immediate conservative breast surgery reconstruction.
BACKGROUND
Although the lateral thoracodorsal fasciocutaneous flap is a well-studied procedure for late breast reconstruction following radical surgery, there are few previous reports regarding its indication, flap design, and clinical outcome following conservative breast surgery.


METHODS
Thirty-four patients underwent immediate unilateral lateral thoracodorsal fasciocutaneous flap breast reconstructions. Mean time of follow-up was 23 months. The lateral thoracodorsal fasciocutaneous flap was indicated to reconstruct moderate lateral breast defects where there was not enough breast tissue to perform the reconstruction. Flap and donor-site complications were evaluated. Information on aesthetic results and patient satisfaction was collected.


RESULTS
All tumors were located in lateral breast regions, and 64.7 percent measured 2 cm or less (T1). Flap complications occurred in four patients (11.8 percent), with partial flap necrosis in three (8.8 percent). Donor-site complications occurred in eight (23.5 percent), with seroma in five (14.7 percent) and wound dehiscence in three (8.8 percent). The cosmetic result was considered to be good or very good in 88.2 percent, and the majority of patients were either very satisfied or satisfied. Surgical intervention was necessary in two cases of wound dehiscence. Serial dorsal puncture in cases of seroma were performed with satisfactory results.


CONCLUSIONS
The lateral thoracodorsal fasciocutaneous flap is a simple and reliable technique for conservative breast surgery reconstruction. Success depends on patient selection, coordinated planning with the oncologic surgeon, and careful intraoperative management.
Munhoz
Alexandre Mendonça
AM
Division of Plastic Surgery, University of São Paulo School of Medicine, São Paulo, Brazil. munhozalex@uol.com.br
Montag
Eduardo
E
Arruda
Eduardo Gustavo
EG
Aldrighi
Claudia
C
Gemperli
Rolf
R
Aldrighi
José Mendes
JM
Ferreira
Marcus Castro
MC
D000328:Adult; D001943:Breast Neoplasms / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery; D018270:Carcinoma, Ductal, Breast / Q000601:surgery; D017024:Chemotherapy, Adjuvant; D002921:Cicatrix / Q000209:etiology; D003131:Combined Modality Therapy; D004954:Esthetics; D005218:Fat Necrosis / Q000209:etiology; D005260:Female; D005355:Fibrosis; D006801:Humans; D008197:Lymph Node Excision; D016462:Mammaplasty / Q000009:adverse effects / Q000379:methods* / Q000706:statistics & numerical data; D008408:Mastectomy; D008875:Middle Aged; D017060:Patient Satisfaction; D011183:Postoperative Complications / Q000209:etiology; D018714:Radiotherapy, Adjuvant; D012086:Reoperation; D012189:Retrospective Studies; D049291:Seroma / Q000209:etiology; D013524:Surgical Flaps / Q000009:adverse effects / Q000706:statistics & numerical data; D013529:Surgical Wound Dehiscence / Q000601:surgery; D013530:Surgical Wound Infection / Q000209:etiology; D016896:Treatment Outcome