Preventing seroma in the latissimus dorsi flap donor site with fibrin sealant

Donor site seroma continues to be the most common complication of latissimus dorsi flap reconstruction. Numerous preventive methods and treatments have been described. The use of fibrin sealant in the donor site before closure may be an effective means of seroma prevention. The authors evaluated the efficacy of fibrin sealant in conjunction with closed suction drainage in a series of 17 latissimus flap donor sites. They also determined their approximate institutional seroma rate with a retrospective chart review of 20 donor sites. The fibrin sealant patients had a seroma rate of 11.8% compared with a rate of 35% among the untreated patients (P = 0.047). This compares favorably with seroma rates as high as 79% described in the literature. In conclusion, the use of fibrin sealant in the latissimus flap donor site appears to be effective in preventing seroma.