Schwabegger A, Ninković M, Brenner E, Anderl H
University Clinic of Plastic and Reconstructive Surgery, Innsbruck, Austria.
Ann Plast Surg. 1997 Jun;38(6):594-7. doi: 10.1097/00000637-199706000-00005.
This prospective study reveals that the incidence of seroma formation after harvesting the latissimus dorsi muscle by scalpel is reasonably moderate. This incidence is lower when the resulting skin flaps are tacked to the underlying structures with resorbable sutures. In contrast, electrocautery dissection shows a significantly much higher rate of seroma formation, probably because of thermal injury of the wide fascial wound layers or the subcutaneous fat tissue. Fifty-eight patients were distributed among three groups. Within each group a specific way of latissimus dorsi muscle harvesting and donor site treatment was accomplished. The group of scalpel dissection and skin flap fixation to the underlying layers with additional tacking sutures shows the lowest rate of seroma formation (9.1%, N = 2) due to the avoidance of shearing effects. A clearly higher incidence is present in the group of scalpel dissection without tacking sutures (38.1%, N = 8), whereas seromas most frequently result after electrocautery dissection without skin flap fixation (80.0%, N = 12).
这项前瞻性研究表明，使用手术刀切取背阔肌后血清肿形成的发生率适中。当用可吸收缝线将形成的皮瓣固定于其下方结构时，该发生率较低。相比之下，电刀分离显示血清肿形成率显著更高，这可能是由于广泛的筋膜伤口层或皮下脂肪组织受到热损伤所致。58例患者被分为三组。每组采用特定的背阔肌切取方式及供区处理方法。手术刀分离并使用额外的固定缝线将皮瓣固定于下层组织的组血清肿形成率最低（9.1%，N = 2），这是因为避免了剪切效应。在未使用固定缝线的手术刀分离组中发生率明显更高（38.1%，N = 8），而在未进行皮瓣固定的电刀分离后血清肿最常出现（80.0%，N = 12）。
