D28. Indications of the Latissimus Dorsi Flap in a Microsurgery Breast Reconstruction Practice

PURPOSE: Breast reconstruction following mastectomy is a critical component of comprehensive care for breast cancer patients. The latissimus dorsi (LD) flap procedure has been a valuable tool in this regard, but with an increasing emphasis on microsurgery in recent years, it becomes imperative to reevaluate its role and applications in a microsurgery practice. METHODS: An IRB approved retrospective review of patient data stored within a REDCap database was performed from January 2012 to December 2022. The study cohort encompassed 61 patients who had undergone LD flap for breast reconstruction in a single institution. RESULTS: The average age was 51.3 years (±8.2 SD) and average BMI was 27.1 (±11.3 SD). Indications for the surgery were primary breast reconstruction as an adjunct to implant-based reconstruction (61%), salvage of implant-based reconstruction (11.4%), salvage for free flap reconstruction (11.4%), adjunct to free flap reconstruction (7.6%), primary breast reconstruction without implant (6.3%), and chest wall reconstruction (2.5%). CONCLUSION: In an evolving landscape where flaps like DIEPs, PAPs, and LAPS are gaining prominence, the utilization of latissimus dorsi flaps in breast reconstruction has declined. However, our study reaffirms the enduring relevance of LD flaps, as they continue to yield favorable outcomes with complication rates that are on par with their counterparts. Despite the shifting trends in reconstructive surgery, the LD flap maintains a valuable and distinctive role, demonstrating its continued importance in this evolving field.