Latissimus Dorsi (MSLD) and Latissimus Dorsi (LD) flap breast

Published Date: 19th July 2016

Publication Authors: , Shaaban H, , Iqbal A

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Introduction: 

The Muscle Sparing Latissimus Dorsi (MSLD) flap utilizes only the lateral segment of the muscle containing the descending branch of the thoracodorsal artery with its thoracodorsal artery perforators to supply the skin paddle and fascial components of the flap. The aim of this study was to determine the postoperative analgesic requirements of patients undergoing a standard LD reconstruction compared to the MSLD.

Methods:

Consecutive patients undergoingMSLDand LD breast reconstructions were identified. All patients received postoperative analgesia using morphine via a patient-controlled analgesia (PCA) infusion pump. The patient's weight was used to calculate total morphine dose adjusted for weight (in milligrams per kilogram) in order to allow comparison of requirements. The total operative time and hospital stay were also recorded.

Results:

During the study period 15 patients underwent unilateral MSLD and 20 patients unilateral LD reconstructions. Independent samples t tests revealed a significant difference in postoperative analgesic requirements. The MSLD required significantly less total PCA in comparison to the LD group (MSLD Mean 0.498 mg/kg vs LD 0.935 mg/kg, p<0.05). The MSLD also had a shorter hospital stay (MSLD 5.0 days vs LD 6.85 days, p<0.01). The operative time was similar in both groups. No differences were found for bilateral MSLD and LD reconstructions although the number performed was small.

Conclusion:

The MSLD results in a shorter hospital stay and less postoperative analgesic requirements compared to the LD flap without any additional operative time.

Nassab, R; Shaaban, H; Alvi, R; Iqbal, A. (2013).  A comparative study of analgesic requirements in patients undergoing muscle sparing Latissimus Dorsi (MSLD) and Latissimus Dorsi (LD) flap breast reconstruction . European Journal of Surgical Oncology. 39 (5), 503

 

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