Preoperative imaging for autologous breast reconstruction

2021 ◽  
pp. 1017-1024
Author(s):  
Mark Ashton ◽  
Iain Whitaker
Keyword(s):  
Breast Reconstruction ◽  
Plastic Surgery ◽  
Vascular Anatomy ◽  
Surgical Reconstruction ◽  
Preoperative Imaging ◽  
Autologous Breast Reconstruction ◽  
Operative Morbidity ◽  
Comprehensive Review ◽  
Recent Advances ◽  
Plastic Surgical Reconstruction

A complete understanding of vascular anatomy is now integral to planning most, if not all, vascularized flaps in plastic surgery. Recent advances in preoperative imaging have provided an unheralded ability to investigate the vascular anatomy of planned donor and recipient sites for plastic surgical reconstruction, and as such, have been associated with a significant decrease in operative morbidity, operative time, and surgeon stress. This chapter provides a comprehensive review of the most recent advances in preoperative planning investigations for plastic surgery in the thorax and abdomen and autologous breast reconstruction.

Prevalence and Utilization of Obturator Artery Anatomic Variant in Autologous Breast Reconstruction

2020 ◽  
Author(s):  
Katherine D. Reuter Muñoz ◽  
Jeremy M. Powers ◽  
Shuhao Zhang ◽  
Santosh S. Kale
Keyword(s):  
Breast Reconstruction ◽  
Internal Mammary Artery ◽  
Vascular Anatomy ◽  
Autologous Breast Reconstruction ◽  
Obturator Artery ◽  
Anatomic Variant ◽  
Epigastric Artery ◽  
Internal Mammary ◽  
Deep Inferior Epigastric Artery ◽  
Flow Through

Abstract Background The objective of this study is to quantify the prevalence and describe the utilization of an anatomic vascular variant in which the obturator artery (OA) arises from the trunk of the deep inferior epigastric artery (DIEA) in stacked/dual-pedicled autologous breast reconstruction. When this variant is identified preoperatively on computed tomography angiography (CTA), it may be utilized in a “flow-through” fashion to direct antegrade internal mammary artery (IMA) flow into a second free flap to facilitate anastomotic arrangement and optimize perfusion. Methods Preoperatively obtained abdomen/pelvis CTA imaging of 121 autologous breast reconstruction patients were retrospectively reviewed for the unilateral or bilateral presence of the OA branch arising from the DIEA (OA variant). The results were analyzed using descriptive statistics. Results Our analysis revealed the presence of the OA variant in 60 of the 121 (49.6%) breast reconstruction candidates, either unilaterally or bilaterally. Out of these patients, the variant was present unilaterally in 33 (55%) and bilaterally in 27 (45%) patients. Of the unilateral variants, 12 (36.4%) patients demonstrated right-sided laterality, while 21 (63.6%) patients demonstrated left-sided laterality. Clinically, this anatomic variant has been utilized in several cases of autologous breast reconstruction with flap survival in all cases. Conclusion Utilization of this anatomic variant in stacked or dual-pedicled autologous breast reconstruction results in antegrade IMA perfusion of both primary and secondary flaps, as well as improved size match compared with other anastomotic options. Knowledge of the vascular anatomy and variations in the inferior epigastric system is crucial to both preventing complications and optimizing flap planning and outcome.

The evolution of autologous breast reconstruction

2020 ◽  
Vol 26 (11) ◽  
pp. 2223-2225
Author(s):  
Domenico Costanzo ◽  
Marco Klinger ◽  
Andrea Lisa ◽  
Luca Maione ◽  
Andrea Battistini ◽  
...  
Keyword(s):  
Breast Reconstruction ◽  
Autologous Breast Reconstruction

scholarly journals Conducting polymers: a comprehensive review on recent advances in synthesis, properties and applications

RSC Advances ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. 5659-5697 ◽  
Author(s):  
Namsheer K ◽  
Chandra Sekhar Rout
Keyword(s):  
Mechanical Properties ◽  
Electrical Property ◽  
Conducting Polymers ◽  
Inorganic Materials ◽  
Environmental Stability ◽  
Comprehensive Review ◽  
Recent Advances ◽  
Synthesis Properties

Conducting polymers are extensively studied due to their outstanding properties, including tunable electrical property, optical and high mechanical properties, easy synthesis and effortless fabrication and high environmental stability over conventional inorganic materials.

Stimuli-responsive organic-inorganic mesoporous silica hybrids: A comprehensive review on synthesis and recent advances

2021 ◽  
Vol 270 ◽  
pp. 115232
Author(s):  
Jerome Peter ◽  
Riyasudheen Nechikkattu ◽  
Anandhu Mohan ◽  
Anju Maria Thomas ◽  
Chang-Sik Ha
Keyword(s):  
Mesoporous Silica ◽  
Stimuli Responsive ◽  
Comprehensive Review ◽  
Recent Advances ◽  
Silica Hybrids

scholarly journals Age and Overweight Are Not Contraindications for a Breast Reconstruction with a TMG-Flap—A Risk and Complication Analysis of a Retrospective Double Center Study Including 300 Patients

2021 ◽  
Vol 10 (5) ◽  
pp. 926
Author(s):  
Karl Schwaiger ◽  
Laurenz Weitgasser ◽  
Maximilian Mahrhofer ◽  
Kathrin Bachleitner ◽  
Selim Abed ◽  
...  
Keyword(s):  
Statistical Analysis ◽  
Postoperative Complications ◽  
Breast Reconstruction ◽  
Data Extraction ◽  
Free Flaps ◽  
Risk Groups ◽  
The Elderly ◽  
Demographic Development ◽  
Autologous Breast Reconstruction ◽  
Significant Difference

Introduction: The transverse myocutaneous gracilis (TMG) flap has become a popular and reliable alternative for autologous breast reconstruction. Initially described as a valuable tissue source for women with low body-mass index, indications nowadays have widely expanded. The Western civilization demographic development with its aging population and the steady growing average BMI has led to increasing breast reconstructions with TMG flaps in overweight and aged individuals. Patients and Methods: A total of 300 TMG free flaps for unilateral autologous breast reconstruction were evaluated in the form of a retrospective double center cohort study. Data extraction, study group formation and statistical analysis (One-way analysis of variance (ANOVA), Pearson’s chi-squared statistical analysis and relative risk calculation) were done specifically to evaluate age and BMI as risk factors for postoperative complications and outcome. Results: No significant differences in patients’ age and BMI in the complication groups compared to the no-complication group could be found. No significant difference regarding the occurrence of complications could be found in any of the formed risk-groups. No significant increase of minor-, major- or overall complications, flap loss or revision surgeries were found in the elderly patient groups or for patients with overweight. Conclusion: Age and overweight do not significantly increase the risk for postoperative complications after breast reconstructions with free TMG flaps. The findings of this study support the fact that microsurgical breast reconstruction with a free TMG flap should not solely be reserved for younger patients and females with a lower BMI.

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