Heterologous reconstruction and radiotherapy: the role of latissimus dorsi flap as a salvage.

AIM: The versatility and effectiveness of the latissimus dorsi flap as salvage in complicated heterologous reconstructions, especially with regards to radiotherapy, is examined in this retrospective review of our 10-year experience.

METHOD: Twenty-eight patients with complicated heterologous reconstruction were divided into three groups: (1) 15 patients with mastectomy and immediately expander reconstruction and radiation; (2) 9 patients with previous QUART, salvage mastectomy and immediate expander reconstruction; (3) 4 patients with radical mastectomy without radiation.

RESULTS: The most common complications were capsular contracture and radiodermitis in Group 1, cutaneous fistula in Group 2. Recipient site complications, after latissimus dorsi flap, were observed in seven patients (five smokers), five in Group 1, two in Group 2. Cosmetic result was scored excellent and good in 25 patients (89%).

CONCLUSION: This study shows as a favourable and cosmetically satisfactory reconstruction can be achieved when combining an implant with a latissimus dorsi flap allowing the salvage of the entire heterologous reconstruction.