Abstract
Background Seroma formation is the most common donor site complication following autologous
breast reconstruction, along with hematoma. Seroma may lead to patient discomfort
and may prolong hospital stay or delay adjuvant treatment. The aim of this study was
to compare seroma rates between the deep inferior epigastric perforator (DIEP), transverse
musculocutaneous gracilis (TMG), and superior gluteal artery perforator (SGAP) donor
sites.
Methods The authors conducted a retrospective single-center cohort study consisting of chart
review of all patients who underwent microsurgical breast reconstruction from April
2018 to June 2020. The primary outcome studied was frequency of seroma formation at
the different donor sites. The secondary outcome evaluated potential prognostic properties
associated with seroma formation. Third, the number of donor site seroma evacuations
was compared between the three donor sites.
Results Overall, 242 breast reconstructions were performed in 189 patients. Demographic data
were found statistically comparable between the three flap cohorts, except for body
mass index (BMI). Frequency of seroma formation was highest at the SGAP donor site
(75.0%), followed by the TMG (65.0%), and DIEP (28.6%) donor sites. No association
was found between seroma formation and BMI, age at surgery, smoking status, diabetes
mellitus, neoadjuvant chemotherapy, or DIEP laterality. The mean number of seroma
evacuations was significantly higher in the SGAP and the TMG group compared with the
DIEP group.
Conclusion This study provides a single center's experience regarding seroma formation at the
donor site after microsurgical breast reconstruction. The observed rate of donor site
seroma formation was comparably high, especially in the TMG and SGAP group, necessitating
an adaption of the surgical protocol.
Keywords seroma - mammaplasty - surgical flaps - microsurgery
