Measuring the patient perspective on latissimus dorsi donor site outcomes following breast reconstruction Journal Article

Authors: Browne, J. P.; Jeevan, R.; Pusic, A. L.; Klassen, A. F.; Gulliver-Clarke, C.; Pereira, J.; Caddy, C. M.; Cano, S. J.
Article Title: Measuring the patient perspective on latissimus dorsi donor site outcomes following breast reconstruction
Abstract: Background: There is little evidence about the long-term donor site outcome of latissimus dorsi breast reconstruction and no patient-reported outcome measures designed specifically for the procedure. Methods: A prospective cohort of breast cancer patients having latissimus dorsi reconstruction after a mastectomy was recruited from 270 hospitals in the United Kingdom. An 18-month follow up questionnaire containing two novel scales was sent to consenting patients. The prevalence of aesthetic and functional morbidity at the donor site was described. The two new scales were refined using the Rasch measurement model and subsequently validated. Results: 1,096 women completed the new scales. 78% of patients reported that no back appearance issues had bothered them “most of the time” or “all of the time” in the past two weeks. The equivalent figure for functional morbidity was 60%. Four items were eliminated following initial psychometric testing. This produced an 8-item Back Appearance scale and an 11-item Back and Shoulder Function scale. Both scales showed adequate fit to the Rasch measurement model. Higher levels of aesthetic and functional bother were observed for completely autologous procedures versus those where latissimus dorsi reconstruction was used to cover an implant (p < 0.05). Higher levels of aesthetic bother were observed in women who had suffered a perioperative complication at the donor site (p = 0.003). Conclusion: These results can inform patients of the morbidity associated with latissimus dorsi reconstruction. The new scales can be used to compare groups undergoing different variations of the procedure and to monitor individual patients. © 2017 British Association of Plastic, Reconstructive and Aesthetic Surgeons
Keywords: breast reconstruction; psychometrics; outcome measures; latissimus dorsi myocutaneous flap
Journal Title: Journal of Plastic Reconstructive and Aesthetic Surgery
Volume: 71
Issue: 3
ISSN: 1748-6815
Publisher: Elsevier Science, Inc.  
Date Published: 2018-03-01
Start Page: 336
End Page: 343
Language: English
DOI: 10.1016/j.bjps.2017.08.028
PROVIDER: scopus
PUBMED: 28958570
Notes: Article -- Export Date: 1 March 2018 -- Source: Scopus
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MSK Authors
  1. Andrea Pusic
    285 Pusic