title: Feasibility of use of a barbed suture (v-loc 180) for quilting the donor site in latissimus dorsi myocutaneous flap breast reconstruction.
abstract: BACKGROUND
  Latissimus dorsi (LD) myocutaneous flap is a popular method of breast reconstruction which can be associated with high incidence of seroma formation. Quilting sutures at the harvest site are used to reduce this. Barbed sutures are self anchoring sutures which avoid multiple knotting and can be useful in quilting.
  
  
  METHODS
  A retrospective analysis of prospectively maintained database of patients who underwent LD flap breast reconstruction between January 2009 and January 2011 was carried out. Seroma formation at the harvest site, wound related complications, inpatient stay and duration of surgery were analysed and a comparison was made between two groups where quilting was done with barbed (V-Loc) suture and conventional polydioxanone (PDS) II sutures.
  
  
  RESULTS
  Fifty-seven patients were included of which 33 had quilting by V-Loc sutures and in 24 patients PDS II suture was used. Median age in the PDS group was 55 years (interquartile range [IQR)], 45 to 61 years) which was comparable to the V-Loc group (53 years [IQR, 48 to 59 years]; P-value 0.948). Sixteen patients (28%) had significant seroma formation and 5 (9%) patients developed superficial wound dehiscence. Incidences of seroma or wound complications were comparable (P-value 0.378 and 1.00, respectively). Secondary outcomes such as total duration of surgery, total inpatient stay, total amount of drain at the donor site were also similar in two groups.
  
  
  CONCLUSIONS
  Use of barbed sutures for quilting the donor site in LD flap reconstruction is a feasible option and the associated seroma formation and wound complications are comparable with conventional sutures.
authors.affiliation: Department of Oncoplastic Breast Surgery, Castle Hill Hospital, Hull and East Yorkshire Hospitals NHS Trust, Cottingham, East Yorkshire, UK.
authors.forename: Dinesh Kumar
authors.initials: DK
authors.lastname: Thekkinkattil
authors.forename: Tasadooq
authors.initials: T
authors.lastname: Hussain
authors.forename: Tapan Kumar
authors.initials: TK
authors.lastname: Mahapatra
authors.forename: Penelope Louise
authors.initials: PL
authors.lastname: McManus
authors.forename: Peter John
authors.initials: PJ
authors.lastname: Kneeshaw
keywords: Barbed suture; Latissimus dorsi flap; Quilting; Seroma; V-Loc