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

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dc.contributor.author Browne, John P.
dc.contributor.author Jeevan, Ranjeet
dc.contributor.author Pusic, Andrea L.
dc.contributor.author Klassen, Anne F.
dc.contributor.author Gulliver-Clarke, Carmel
dc.contributor.author Pereira, Jerome
dc.contributor.author Caddy, Christopher M.
dc.contributor.author Cano, Stefan J.
dc.date.accessioned 2017-10-04T15:45:37Z
dc.date.available 2017-10-04T15:45:37Z
dc.date.issued 2017-09-13
dc.identifier.citation Browne, J. P., Jeevan, R., Pusic, A. L., Klassen, A. F., Gulliver-Clarke, C., Pereira, J., Caddy, C. M. and Cano, S. J. (2017) 'Measuring the patient perspective on latissimus dorsi donor site outcomes following breast reconstruction', Journal of Plastic, Reconstructive & Aesthetic Surgery, In Press, doi: 10.1016/j.bjps.2017.08.028 en
dc.identifier.startpage 1 en
dc.identifier.endpage 33 en
dc.identifier.issn 1748-6815
dc.identifier.uri http://hdl.handle.net/10468/4832
dc.identifier.doi 10.1016/j.bjps.2017.08.028
dc.description.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. en
dc.format.mimetype application/pdf en
dc.language.iso en en
dc.publisher Elsevier Ltd. en
dc.relation.uri http://www.sciencedirect.com/science/article/pii/S1748681517303637
dc.rights © 2017 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. This manuscript version is made available under the CC BY-NC-ND 4.0 license. en
dc.rights.uri http://creativecommons.org/licenses/by-nc-nd/4.0/ en
dc.subject Latissimus Dorsi Myocutaneous Flap en
dc.subject Breast reconstruction en
dc.subject Outcome measures en
dc.subject Psychometrics en
dc.title Measuring the patient perspective on latissimus dorsi donor site outcomes following breast reconstruction en
dc.type Article (peer-reviewed) en
dc.internal.authorcontactother John Patrick Browne, Epidemiology & Public Health, University College Cork, Cork, Ireland. +353-21-490-3000 Email: j.browne@ucc.ie en
dc.internal.availability Full text available en
dc.check.info Access to this article is restricted for 12 months after publication by request of the publisher. en
dc.check.date 2018-09-13
dc.date.updated 2017-10-04T15:38:38Z
dc.description.version Accepted Version en
dc.internal.rssid 413576197
dc.description.status Peer reviewed en
dc.identifier.journaltitle Journal Of Plastic, Reconstructive & Aesthetic Surgery en
dc.internal.copyrightchecked No !!CORA!! en
dc.internal.licenseacceptance Yes en
dc.internal.IRISemailaddress j.browne@ucc.ie en


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© 2017 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. This manuscript version is made available under the CC BY-NC-ND 4.0 license. Except where otherwise noted, this item's license is described as © 2017 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. This manuscript version is made available under the CC BY-NC-ND 4.0 license.
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