BEYOND RECONSTRUCTION: ASSESSING THE DUAL ROLE OF THE LD FLAP IN AESTHETIC AND LYMPHATIC RESTORATION drgitikananda@gmail.com

 

BEYOND RECONSTRUCTION: ASSESSING THE DUAL ROLE OF THE LD FLAP IN AESTHETIC AND LYMPHATIC RESTORATION

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India

Oral or Poster

This study aims to evaluate lymphatic function development post Modified Radical Mastectomy(MRM) in patients undergoing Lattismus Dorsi(LD) flap reconstruction, by lymphoscintigraphy and assess the incidence of lymphedema using arm circumference difference measurements and correlating both

This cohort study enrolled 21 post-MRM patients who underwent immediate LD flap reconstruction, assessed at 3, 6 and 12 months, where Lymphatic Function Development (LFD) was evaluated using lymphoscintigraphy, categorized as Nil, Partial, or Full. Arm morbidity was quantified by circumferential arm measurement difference in both arms to track lymphedema. Analysis was performed to correlate LFD with lymphoedema and to assess impact of various factors on development of lymphoedema

At 3-months,all patients exhibited Nil LFD. Significant lymphatic regeneration was observed by 12 months, 52.4% of patients achieved Full LFD and 14.3% achieved Partial LFD (p<0.01). This functional improvement demonstrated a strong inverse correlation with clinical morbidity, as higher LFD grades were associated with a significant reduction in arm circumference difference (p<0.01).Flap size was found a critical determinant of success; patients achieving Full LFD had a significantly larger mean flap area (81.1 cm²) compared to those with Nil LFD (56.1 cm², p<0.01). Local site infection was found to significantly delay LFD progression (p=0.02)

LD flap is more than a reconstructive implant; it is a functional asset that may actively restore lymphatic drainage. It reduces post-mastectomy lymphedema, with larger flaps yielding superior outcomes. The LD flap may be considered a powerful therapeutic technique for the comprehensive rehabilitation of breast cancer survivors