Does Suction Strategy Using a Negative-Pressure Wound Therapy System at the Extended Latissimus Dorsi Flap Donor Site After Breast Reconstruction Contribute to a Reduction in Seroma Formation?

BACKGROUND

This study aimed to evaluate the impact of different drainage systems on seroma formation at the donor site following breast reconstruction with extended latissimus dorsi (ELD) flaps.

METHODS

A retrospective chart review included all patients who underwent ELD flap breast reconstruction between January 2014 and December 2025. Patients were divided into two groups: high-negative-pressure drainage using a negative-pressure wound therapy (NPWT) device and conventional drainage. One-to-one propensity score matching based on age and body mass index minimized selection bias.

RESULTS

The initial cohort included 64 patients (NPWT: n = 26; conventional: n = 38), and propensity score matching yielded 22 pairs. In the propensity-matched cohort, the median daily drainage volume on postoperative day 11 (immediately before drain removal) was significantly lower in the NPWT group than in the conventional group (22.0 [IQR: 14.0-31.5] mL/day vs. 45.0 [IQR: 34.3-56.3] mL/day; p = <0.001). However, no significant between-group differences were observed in the rate of postoperative seroma formation (72.7% vs. 86.4%; p = 0.457), median total aspirated volume after drain removal (46.5 [IQR: 2.3-124.3] mL vs. 79.5 [IQR: 44.0-145.3] mL; p = 0.294), or median duration of seroma persistence (2.0 [IQR: 0.3-3.8] weeks vs. 4.0 [IQR: 3.0-5.0] weeks; p = 0.083).

CONCLUSIONS

Drainage using the NPWT device did not significantly prevent donor-site seroma formation compared with conventional drainage.

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