Immediate Breast Reconstruction with Stacked Diep Flap

2014 ◽  
Vol 30 (S 01) ◽  
Author(s):  
Carmen Suñé ◽  
David Carrillo ◽  
Cristian Lopez ◽  
Marco Serena Signes ◽  
Alejandra Sainz ◽  
...  
Keyword(s):  
Breast Reconstruction ◽  
Immediate Breast Reconstruction ◽  
Diep Flap

scholarly journals Immediate versus secondary DIEP flap breast reconstruction: a multicenter outcome study

2020 ◽  
Vol 302 (6) ◽  
pp. 1451-1459
Author(s):  
L. Prantl ◽  
N. Moellhoff ◽  
U. von Fritschen ◽  
R. E. Giunta ◽  
G. Germann ◽  
...  
Keyword(s):  
Breast Reconstruction ◽  
Negative Impact ◽  
Current Trend ◽  
Length Of Hospital Stay ◽  
Immediate Breast Reconstruction ◽  
Diep Flap ◽  
Lower Treatment ◽  
Significant Difference ◽  
Delayed Breast Reconstruction ◽  
Group Mobilization

Abstract Purpose Immediate breast reconstruction (IBR) at the time of mastectomy is gaining popularity, as studies show no negative impact on recurrence or patient survival, but better aesthetic outcome, less psychological distress and lower treatment costs. Using the largest database available in Europe, the presented study compared outcomes and complications of IBR vs. delayed breast reconstruction (DBR). Methods 3926 female patients underwent 4577 free DIEP-flap breast reconstructions after malignancies in 22 different German breast cancer centers. The cases were divided into two groups according to the time of reconstruction: an IBR and a DBR group. Surgical complications were accounted for and the groups were then compared. Results Overall, the rate of partial-(1.0 versus 1.2 percent of cases; p = 0.706) and total flap loss (2.3 versus 1.9 percent of cases; p = 0.516) showed no significant difference between the groups. The rate of revision surgery was slightly, but significantly lower in the IBR group (7.7 versus 9.8 percent; p = 0.039). Postoperative mobilization was commenced significantly earlier in the IBR group (mobilization on postoperative day 1: 82.1 versus 68.7 percent; p < 0.001), and concordantly the mean length of hospital stay was significantly shorter (7.3 (SD3.7) versus 8.9 (SD13.0) days; p < 0.001). Conclusion IBR is feasible and cannot be considered a risk factor for complications or flap outcome. Our results support the current trend towards an increasing number of IBR. Especially in times of economic pressure in health care, the importance of a decrease of hospitalization cannot be overemphasized.

scholarly journals Immediate breast reconstruction with a ‘modified fleur-de-lis’ abdominal-free flap in a patient with previous abdominal surgery

2018 ◽  
Vol 51 (01) ◽  
pp. 089-092
Author(s):  
Manuel Robustillo ◽  
Luis Parra Pont ◽  
Georgios Pafitanis ◽  
Pedro Ciudad ◽  
Daniel Grandes ◽  
...  
Keyword(s):  
Abdominal Surgery ◽  
Breast Reconstruction ◽  
Blood Supply ◽  
Donor Site ◽  
Immediate Breast Reconstruction ◽  
Diep Flap ◽  
Gold Standard Method ◽  
Previous Abdominal Surgery ◽  
Large Breast ◽  
Small Breast

ABSTRACTDIEP flap has become the gold standard method for patients undergoing autologous breast reconstruction; however, previous surgery or scars in the abdominal area have been considered a relative contraindication for the use of abdominal tissue. Longitudinal midline abdominal scars may be specially problematic because of the poor midline crossover of blood and the high risk of necrosis of the distal flap. Patients with small breast may be easily reconstructed with hemi-DIEP flap; however, patients with large breast need more tissue available. Our aim is to report a modification of a ‘fleur-de-lis pattern’ for a breast reconstruction in a patient with previous abdominal surgery and large breast. The post-operative course was uneventful, flap did not show blood supply compromise, volume and symmetry are preserved after 6 months post-operative and donor site morbidity has not been observed. This modification may be very useful to avoid complications related to poor blood supply associated with scar tissues. Careful pre-operative planning and the transfer of only well-vascularised tissue are essential for a successful reconstruction.

Bilateral DIEP Flap Breast Reconstruction on One Single Internal Mammary Pedicle

2005 ◽  
Vol 21 (07) ◽  
Author(s):  
Koenraad Landuyt ◽  
Moustapha Hamdi ◽  
Phillip Blondeel ◽  
Nathalie Roche ◽  
Stanislas Monstrey
Keyword(s):  
Breast Reconstruction ◽  
Diep Flap ◽  
Internal Mammary

scholarly journals Exploring personalized postoperative non-invasive tissue oximetry in DIEP flap breast reconstruction

2021 ◽  
Author(s):  
Anouk A. M. A. Lindelauf ◽  
Nousjka P. A. Vranken ◽  
Rutger M. Schols ◽  
Esther A. C. Bouman ◽  
Patrick W. Weerwind ◽  
...  
Keyword(s):  
Early Detection ◽  
Breast Reconstruction ◽  
Near Infrared ◽  
Diep Flap ◽  
Baseline Measurement ◽  
Flap Surgery ◽  
Level Of Evidence ◽  
Non Invasive ◽  
Vascular Compromise ◽  
Tissue Oximetry

Abstract Early detection of vascular compromise after autologous breast reconstruction is crucial to enable timely re-exploration for flap salvage. Several studies proposed non-invasive tissue oximetry for early identification of ischemia of deep inferior epigastric perforator (DIEP) flaps. The present study aimed to explore the utility of non-invasive tissue oximetry following DIEP flap surgery using a personalized oxygenation threshold. Methods Patients undergoing immediate/delayed DIEP flap surgery were included in this prospective observational study. DIEP flap tissue oxygenation (StO2) was monitored continuously using near-infrared spectroscopy. A baseline measurement was performed by positioning one sensor at the marked position of the major inferior epigastric perforator on the abdomen. A new sensor was positioned postoperatively on the transplanted tissue. In unilateral procedures, postoperative StO2 values of the native breast were also obtained. Measurements were continued for 24 h. Results Thirty patients (42 flaps) were included. Fourteen patients (46.7%) had an uncomplicated postoperative course. A minor complication was observed in thirteen patients; in five patients, at least one major complication occurred, requiring re-exploration. Median StO2 readings were significantly lower in patients with major complications compared to uncomplicated cases. In fourteen unilateral DIEP flap procedures, StO2 values of the native breast were similar to the preoperative baseline measurement (92%; p = 0.452). Conclusions Non-invasive tissue oximetry following DIEP flap surgery could aid in early detection of vascular compromise. StO2 values of the native breast and abdominal wall preoperatively can be used interchangeably and can serve as personalized reference value. Level of evidence: Level IV, diagnostic / prognostic study.

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