BACKGROUND: Donor site seroma is the most frequent and troublesome complication of latissimus dorsi (LP) flaps. This study aimed to identify the risk factors of seroma formation after an LD flap and to evaluate the biochemical composition of seromas. METHODS: The medical records of 84 patients who underwent an LD flap from September 2007 to May 2017 were reviewed. Age; body mass index (BMI); the type of breast surgery, reconstruction, and nodal dissection; the usage of fibrin glue; smoking; chemotherapy; and history of diabetes mellitus or hypertension were evaluated. In 11 of the 84 patients, the levels of electrolytes, glucose, proteins, lipids, and inflammatory markers present in seromas were investigated. RESULTS: The overall incidence of seroma was 66.7%. Advanced age (≥45 years) and overweight (BMI ≥23 kg/m²) were significant risk factors for seroma. Patients who underwent an extended LD flap had a higher incidence of seroma than those who underwent a standard LD flap, while those who underwent breast-conserving surgery had a lower incidence of seroma than those who underwent other breast procedures. Lactate dehydrogenase (LDH) levels in seromas on postoperative day 2 demonstrated a positive linear correlation with the duration of drainage, but this relationship did not reach statistical significance. CONCLUSIONS: Advanced age, overweight, wider excision or mastectomy, and use of an extended LD flap were found to be risk factors for seroma formation after breast reconstruction with an LD flap. It may be possible to infer whether a seroma will be long-lasting by measuring LDH levels in the seroma.
Body Mass Index ; Breast* ; Diabetes Mellitus ; Drainage ; Drug Therapy ; Electrolytes ; Female ; Fibrin Tissue Adhesive ; Glucose ; Humans ; Hypertension ; Incidence ; L-Lactate Dehydrogenase ; Mammaplasty* ; Mastectomy ; Mastectomy, Segmental ; Medical Records ; Overweight ; Risk Factors* ; Seroma* ; Smoke ; Smoking ; Superficial Back Muscles* ; Surgical Flaps ; Tissue Donors*

Cigarette smoke is a major risk factor for several diseases, including chronic obstructive pulmonary and cardiovascular diseases. The toxicity of the cigarette smoke can be determined in vitro. The cytotoxicity test of the cigarette smoke is commonly conducted using the cigarette smoke condensate (CSC) and cigarette smoke extract (CSE). The CSC and CSE methods are well known for sampling of the particles and water-soluble compounds in the cigarette smoke, respectively. In this study, the CSC and CSE were analyzed by using a gas chromatography-mass spectrometry (GC-MS) system equipped with a wax column for separation of the volatile organic compounds. The cytotoxic effect of the CSC and CSE were evaluated thoroughly by comparing the analytical results of the CSC and CSE samples. The total concentration of the volatile organic compounds detected in the CSC sample was similar to that in the CSE sample based on the peak area. Except for the dimethyl sulfoxide solvent, nicotine had the highest concentration in the CSC sample, while acetonitrile had the highest concentration in the CSE sample. The compositions were as follows: (1) CSC sample: 55.8% nicotine, 18.0% nicotyrine, 3.20% 1,2,3-propanetriol, triacetate, 1.28% ethyl chloride, 1.22% phenol, etc. and (2) CSE sample: 18.7% acetonitrile, 18.0% acetone, 12.5% 2-hydroxy-2-methyl-propanenitrile, 8.98% nicotine, 5.86% nicotyrine, etc. In this manner, to accurately examine the cytotoxicity of the cigarette smoke using CSC or CSE, the components and their concentrations in the CSC and CSE samples should be considered.
Acetone ; Cardiovascular Diseases ; Dimethyl Sulfoxide ; Ethyl Chloride ; Gas Chromatography-Mass Spectrometry ; In Vitro Techniques ; Nicotine ; Phenol ; Risk Factors ; Smoke* ; Tobacco Products* ; Volatile Organic Compounds*

Cigarette smoke is a major risk factor for several diseases, including chronic obstructive pulmonary and cardiovascular diseases. The toxicity of the cigarette smoke can be determined in vitro. The cytotoxicity test of the cigarette smoke is commonly conducted using the cigarette smoke condensate (CSC) and cigarette smoke extract (CSE). The CSC and CSE methods are well known for sampling of the particles and water-soluble compounds in the cigarette smoke, respectively. In this study, the CSC and CSE were analyzed by using a gas chromatography-mass spectrometry (GC-MS) system equipped with a wax column for separation of the volatile organic compounds. The cytotoxic effect of the CSC and CSE were evaluated thoroughly by comparing the analytical results of the CSC and CSE samples. The total concentration of the volatile organic compounds detected in the CSC sample was similar to that in the CSE sample based on the peak area. Except for the dimethyl sulfoxide solvent, nicotine had the highest concentration in the CSC sample, while acetonitrile had the highest concentration in the CSE sample. The compositions were as follows: (1) CSC sample: 55.8% nicotine, 18.0% nicotyrine, 3.20% 1,2,3-propanetriol, triacetate, 1.28% ethyl chloride, 1.22% phenol, etc. and (2) CSE sample: 18.7% acetonitrile, 18.0% acetone, 12.5% 2-hydroxy-2-methyl-propanenitrile, 8.98% nicotine, 5.86% nicotyrine, etc. In this manner, to accurately examine the cytotoxicity of the cigarette smoke using CSC or CSE, the components and their concentrations in the CSC and CSE samples should be considered.
Acetone ; Cardiovascular Diseases ; Dimethyl Sulfoxide ; Ethyl Chloride ; Gas Chromatography-Mass Spectrometry ; In Vitro Techniques ; Nicotine ; Phenol ; Risk Factors ; Smoke ; Tobacco Products ; Volatile Organic Compounds