title: An analysis of 277 consecutive latissimus dorsi breast reconstructions: a focus on capsular contracture.
abstract: BACKGROUND
  Breast reconstruction by means of a latissimus dorsi myocutaneous flap in combination with a prosthesis is a well-established technique. Previous published series have highlighted significant rates of local complications, including capsular contracture.
  
  
  METHODS
  A retrospective analysis of latissimus dorsi myocutaneous flap reconstructions performed between 2000 and 2010 was undertaken. A standardized preoperative, perioperative, and postoperative clinical protocol was applied to all cases, which included the use of textured, cohesive-gel silicone implants.
  
  
  RESULTS
  Two hundred seventy-seven procedures were performed in 243 patients, with one-third being immediate reconstructions. The mean age at reconstruction was 50.4 years. Mean follow-up was 47 months, and 3.6 percent of patients developed Baker grade III capsular contracture requiring capsulotomy. Chemotherapy provided a protective effect (p = 0.0197) against capsular contracture formation. Previous radiotherapy had no significant influence on symptomatic capsule formation. The rate of infection requiring implant removal was 1.1 percent, and 0.7 percent of mastectomy scars showed evidence of recurrent disease.
  
  
  CONCLUSIONS
  The use of textured, cohesive-gel silicone implants, combined with a standardized surgical approach, can reduce complications in the short- and long-term postoperative period, independent of radiotherapy.
authors.affiliation: Stoke-on-Trent, United Kingdom From the Department of Plastic Surgery, City General Hospital, University Hospitals of North Staffordshire NHS Trust.
authors.forename: Joseph T
authors.initials: JT
authors.lastname: Hardwicke
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Prinsloo
mesh_terms: D000328:Adult; D000368:Aged; D018427:Breast Implants / Q000009:adverse effects*; D005260:Female; D006801:Humans; D057910:Implant Capsular Contracture / Q000209:etiology*; D016462:Mammaplasty / Q000009:adverse effects* / Q000379:methods; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000637:transplantation; D012189:Retrospective Studies; D013524:Surgical Flaps / Q000009:adverse effects*