| Background: Modified radical mastectomy is currently the mainstream surgical treatments for breast cancer.When performing modified radical mastectomy,nipple-areolar complex and fusiform skin would be excised because of the invasion of cancer.The incision of mastectomy depended on tumor location and surgeon’s habits.Latissimus dorsi(LD)flap combined with implant is a common method of breast reconstruction.It is necessary to design the doner site incision and flap transfer method according to the mastectomy incision.Methods: From Jan.2016 to Dec.2020,22 patients receiving breast reconstruction with LD flap(and implant)were included in this study.Before April 2018,the commonly used incision of LD flap in our department was an oblique incision from axilla to spine.Then the LD flap was rotated to anterior chest wall.The incision of LD flap and its transfer were adapted to the mastectomy incision.When the mastectomy incision was horizontal or from lower inner quadrant to upper outer quadrant,the skin paddle of LD flap was transversely oriented and the flap was turned over to anterior chest wall(Type Ⅰ).When the mastectomy incision was from upper inner quadrant to lower outer quadrant,the skin paddle of LD flap was upswept oriented and the flap was rotated to anterior chest wall(Type Ⅱ).The length of the pedicle were adapted to fit the flap transfer.Surgical technique,demographic,satisfaction score and complications were analyzed.Results: All flaps survived well.Donor site seroma occured in 1 of 7 Type Ⅰ patients and 1 of 8 Type Ⅱ patients.Partial marginal necrosis occured in mastectomy skin flaps in1 of 7 Type Ⅰ patients and 1 of 8 Type Ⅱ patients.None of them underwent reoperation.Four patients had mild shoulder dyskinesia.All patients were very satisfied or satisfied with the appearance.Conclusion: Adaption of LD flap design and its transfer to the mastectomy incision facilitates procedure of breast reconstruction and gets high evaluation. |
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