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Feasibility of Use of a Barbed Suture (V-Loc 180) for Quilting the Donor Site in Latissimus Dorsi Myocutaneous Flap Breast Reconstruction

  • Thekkinkattil, Dinesh Kumar (Department of Oncoplastic Breast Surgery, Castle Hill Hospital, Hull and East Yorkshire Hospitals NHS Trust) ;
  • Hussain, Tasadooq (Department of Oncoplastic Breast Surgery, Castle Hill Hospital, Hull and East Yorkshire Hospitals NHS Trust) ;
  • Mahapatra, Tapan Kumar (Department of Oncoplastic Breast Surgery, Castle Hill Hospital, Hull and East Yorkshire Hospitals NHS Trust) ;
  • McManus, Penelope Louise (Department of Oncoplastic Breast Surgery, Castle Hill Hospital, Hull and East Yorkshire Hospitals NHS Trust) ;
  • Kneeshaw, Peter John (Department of Oncoplastic Breast Surgery, Castle Hill Hospital, Hull and East Yorkshire Hospitals NHS Trust)
  • 투고 : 2012.12.04
  • 심사 : 2013.01.10
  • 발행 : 2013.03.15

초록

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.

키워드

참고문헌

  1. Tomita K, Yano K, Masuoka T, et al. Postoperative seroma formation in breast reconstruction with latissimus dorsi flaps: a retrospective study of 174 consecutive cases. Ann Plast Surg 2007;59:149-51. https://doi.org/10.1097/SAP.0b013e31802c54ef
  2. Bailey SH, Oni G, Guevara R, et al. Latissimus dorsi donorsite morbidity: the combination of quilting and fibrin sealant reduce length of drain placement and seroma rate. Ann Plast Surg 2012;68:555-8. https://doi.org/10.1097/SAP.0b013e318216b65c
  3. Clough KB, Louis-Sylvestre C, Fitoussi A, et al. Donor site sequelae after autologous breast reconstruction with an extended latissimus dorsi flap. Plast Reconstr Surg 2002;109: 1904-11. https://doi.org/10.1097/00006534-200205000-00020
  4. Rios JL, Pollock T, Adams WP Jr. Progressive tension sutures to prevent seroma formation after latissimus dorsi harvest. Plast Reconstr Surg 2003;112:1779-83. https://doi.org/10.1097/01.PRS.0000090542.68560.69
  5. Weinrach JC, Cronin ED, Smith BK, et al. Preventing seroma in the latissimus dorsi flap donor site with fibrin sealant. Ann Plast Surg 2004;53:12-6. https://doi.org/10.1097/01.sap.0000112286.30212.12
  6. Cha HG, Kang SG, Shin HS, et al. Does fibrin sealant reduce seroma after immediate breast reconstruction utilizing a latissimus dorsi myocutaneous flap? Arch Plast Surg 2012;39:504-8. https://doi.org/10.5999/aps.2012.39.5.504
  7. Shin IS, Lee DW, Lew DH. Efficacy of quilting sutures and fibrin sealant together for prevention of seroma in extended latissimus dorsi flap donor sites. Arch Plast Surg 2012;39: 509-13. https://doi.org/10.5999/aps.2012.39.5.509
  8. Menke H, Erkens M, Olbrisch RR. Evolving concepts in breast reconstruction with latissimus dorsi flaps: results and follow-up of 121 consecutive patients. Ann Plast Surg 2001; 47:107-14. https://doi.org/10.1097/00000637-200108000-00001
  9. Bacilious N, Kulber DA, Peters ED, et al. Harvesting of the latissimus dorsi muscle: a small animal model for seroma formation. Microsurgery 1995;16:646-9. https://doi.org/10.1002/micr.1920160911
  10. Jain PK, Sowdi R, Anderson AD, et al. Randomized clinical trial investigating the use of drains and fibrin sealant following surgery for breast cancer. Br J Surg 2004;91:54-60. https://doi.org/10.1002/bjs.4435
  11. Daltrey I, Thomson H, Hussien M, et al. Randomized clinical trial of the effect of quilting latissimus dorsi flap donor site on seroma formation. Br J Surg 2006;93:825-30. https://doi.org/10.1002/bjs.5434
  12. Sierra DH, Feldman DS, Saltz R, et al. A method to determine shear adhesive strength of fibrin sealants. J Appl Biomater 1992;3:147-51. https://doi.org/10.1002/jab.770030210
  13. Cipolla C, Fricano S, Vieni S, et al. Does the use of fibrin glue prevent seroma formation after axillary lymphadenectomy for breast cancer? A prospective randomized trial in 159 patients. J Surg Oncol 2010;101:600-3. https://doi.org/10.1002/jso.21531
  14. Callaghan CJ, Couto E, Kerin MJ, et al. Breast reconstruction in the United Kingdom and Ireland. Br J Surg 2002;89: 335-40. https://doi.org/10.1046/j.0007-1323.2001.02027.x
  15. McKenzie AR. An experimental multiple barbed suture for the long flexor tendons of the palm and fingers: preliminary report. J Bone Joint Surg Br 1967;49:440-7. https://doi.org/10.2106/00004623-196749030-00002
  16. Greenberg JA. The use of barbed sutures in obstetrics and gynecology. Rev Obstet Gynecol 2010;3:82-91.
  17. Kim JC, Lee YK, Lim BS, et al. Comparison of tensile and knot security properties of surgical sutures. J Mater Sci Mater Med 2007;18:2363-9. https://doi.org/10.1007/s10856-007-3114-6
  18. Molokova OA, Kecherukov AI, Aliev F, et al. Tissue reactions to modern suturing material in colorectal surgery. Bull Exp Biol Med 2007;143:767-70. https://doi.org/10.1007/s10517-007-0236-2
  19. Murtha AP, Kaplan AL, Paglia MJ, et al. Evaluation of a novel technique for wound closure using a barbed suture. Plast Re constr Surg 2006;117:1769-80. https://doi.org/10.1097/01.prs.0000209971.08264.b0
  20. Parikh PM, Davison SP, Higgins JP. Barbed suture tenorrhaphy: an ex vivo biomechanical analysis. Plast Reconstr Surg 2009;124:1551-8. https://doi.org/10.1097/PRS.0b013e3181babb77
  21. Delay E, Gounot N, Bouillot A, et al. Autologous latissimus breast reconstruction: a 3-year clinical experience with 100 patients. Plast Reconstr Surg 1998;102:1461-78. https://doi.org/10.1097/00006534-199810000-00020
  22. Hogstrom H, Haglund U, Zederfeldt B. Tension leads to increased neutrophil accumulation and decreased laparotomy wound strength. Surgery 1990;107:215-9.
  23. Mulholland RS, Paul MD. Lifting and wound closure with barbed sutures. Clin Plast Surg 2011;38:521-35. https://doi.org/10.1016/j.cps.2011.06.002
  24. van Rijssel EJ, Brand R, Admiraal C, et al. Tissue reaction and surgical knots: the effect of suture size, knot configuration, and knot volume. Obstet Gynecol 1989;74:64-8.
  25. Rosen AD. Use of absorbable running barbed suture and progressive tension technique in abdominoplasty: a novel approach. Plast Reconstr Surg 2010;125:1024-7. https://doi.org/10.1097/PRS.0b013e3181cb64f7

피인용 문헌

  1. Seroma Reduction: Using Barbed Sutures (V-Loc) to Close Latissimus Dorsi Donor Sites vol.40, pp.6, 2013, https://doi.org/10.5999/aps.2013.40.6.787
  2. Three delivered cases after single port access laparoscopic myomectomy using V-Loc™180 for myometrial suture vol.31, pp.1, 2013, https://doi.org/10.5180/jsgoe.31.188
  3. A Comparison of Barbed Sutures and Standard Sutures with regard to Wound Cosmesis in Panniculectomy and Reduction Mammoplasty Patients vol.2016, pp.None, 2016, https://doi.org/10.1155/2016/7590396
  4. Technical Feasibility of Enterotomy Closure with Knotless Barbed Suture Material (V-Loc 180) in Esophagojejunostomy Using Linear Stapler during Totally Laparoscopic Total Gastrectomy for Gastric Cance vol.30, pp.4, 2013, https://doi.org/10.1080/08941939.2016.1236857