scholarly journals OP2: Breast Reconstruction with a DIEP Flap in Elderly (>60 Years) Patients

2022 ◽  
Vol 10 (1S) ◽  
pp. 12-12
Author(s):  
Jarna Heikkinen ◽  
Salvatore Giordano
Keyword(s):  
Breast Reconstruction ◽  
Diep Flap

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

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.

scholarly journals Breast softness in patients randomised to postmastectomy breast reconstruction with an expander prosthesis or DIEP flap

2021 ◽  
Author(s):  
Linda Tallroth ◽  
Håkan Brorson ◽  
Nathalie Mobargha ◽  
Patrik Velander ◽  
Stina Klasson ◽  
...  
Keyword(s):  
Breast Reconstruction ◽  
Subjective Evaluation ◽  
Objective Evaluation ◽  
Applanation Tonometry ◽  
Diep Flap ◽  
Level Of Evidence ◽  
Patient Reported ◽  
Delayed Breast Reconstruction ◽  
Level I ◽  
Therapeutic Study

Abstract Background Objectively measured breast softness in reconstructed breasts and its relation to patients’ subjective satisfaction with breast softness has not yet been investigated. The aim of this study was to evaluate breast softness in patients 1 year following delayed breast reconstruction with an expander prosthesis (EP) or deep inferior epigastric perforator (DIEP) flap, using objective and subjective methods. Methods Seventy-three patients were randomised to breast reconstruction with an EP or DIEP flap between 2012 and 2018. Of these, 69 completed objective evaluation at a mean of 25 (standard deviation, SD 9.4) months following breast reconstruction. Objective evaluation included measurements of breast volume, jugulum-nipple distance, clavicular-submammary fold distance, ptosis and Baker scale grading. Breast softness was assessed with applanation tonometry. Subjective evaluation was performed using the BREAST-Q questionnaire. Results Objectively, DIEP flaps were significantly softer than EP breast reconstructions. Non-operated contralateral breasts were significantly softer compared with reconstructed breasts. In the subjective evaluation, the median score on the question (labelled 1.h) “How satisfied or dissatisfied have you been with the softness of your reconstructed breast (s)?” was higher in the DIEP flap group corresponding to greater satisfaction in this group. A fair correlation was found between the applanation tonometry and the patient-reported satisfaction with the reconstructed breast’s softness (rs = 0.37). Conclusions In terms of breast softness, breast reconstructions with DIEP flaps result in more satisfied patients. Concerning applanation tonometry as an objective tool for softness assessment, future studies on interobserver agreement are warranted. Level of evidence: Level I, therapeutic study

SIEA flap leads to an increase in abdominal seroma rates compared to DIEP flap for breast reconstruction

2010 ◽  
Vol 34 (2) ◽  
pp. 87-91 ◽  
Author(s):  
Pouria Moradi ◽  
Charlie Durrant ◽  
Graeme E. Glass ◽  
Evitta Askouni ◽  
Simon Wood ◽  
...  
Keyword(s):  
Breast Reconstruction ◽  
Diep Flap ◽  
Siea Flap

Observations from Implementation of the ERAS Protocol after DIEP Flap Breast Reconstruction

2021 ◽  
Author(s):  
Nicholas T. Haddock ◽  
Ricardo Garza ◽  
Carolyn E. Boyle ◽  
Sumeet S. Teotia
Keyword(s):  
Breast Reconstruction ◽  
Patient Outcomes ◽  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Compliance Rate ◽  
Fluid Management ◽  
Control Group ◽  
Diep Flap ◽  
Deep Inferior Epigastric Perforator ◽  
Eras Protocol

Abstract Background The Enhanced Recovery After Surgery (ERAS) protocol is a multivariate intervention requiring the help of several departments, including anesthesia, nursing, and surgery. This study seeks to observe ERAS compliance rates and obstacles for its implementation at a single academic institution. Methods This is a retrospective study looking at patients who underwent deep inferior epigastric perforator (DIEP) flap breast reconstruction from January 2016 to September 2019. The ERAS protocol was implemented on select patients early 2017, with patients from 2016 acting as a control. Thirteen points from the protocol were identified and gathered from the patient's electronic medical record (EMR) to evaluate compliance. Results Two hundred and six patients were eligible for the study, with 67 on the control group. An average of 6.97 components were met in the pre-ERAS group. This number rose to 8.33 by the end of 2017. Compliance peaked with 10.53 components met at the beginning of 2019. The interventions most responsible for this increase were administration of preoperative medications, goal-oriented intraoperative fluid management, and administration of scheduled gabapentin postoperatively. The least met criterion was intraoperative ketamine goal of >0.2 mg/kg/h, with a maximum compliance rate of 8.69% of the time. Conclusion The introduction of new protocols can take over a year for full implementation. This is especially true for protocols as complex as an ERAS pathway. Even after years of consistent use, compliance gaps remain. Staff-, patient-, or resource-related issues are responsible for these discrepancies. It is important to identify these issues to address them and optimize patient outcomes.

scholarly journals Analysis on the Effect of Application of the DIEP Flap in Breast Reconstruction Surgery

2018 ◽  
Vol 2 (1) ◽  
Author(s):  
Tan Jia Liang
Keyword(s):  
Breast Cancer ◽  
Breast Reconstruction ◽  
Chest Wall ◽  
Early Stage ◽  
Developed Countries ◽  
Breast Cancer Surgery ◽  
Sex Reassignment Surgery ◽  
Diep Flap ◽  
Breast Reduction Surgery ◽  
Reconstruction Surgery

Breast reconstruction surgery means using autologous tissue grafts and breast prosthesis to rebuild chest wall deformities and the absence of breast caused by post mastectomy, which are possibly due to burns, trauma, infections, congenital dysplasia and sex reassignment surgery etc., with the prevalence of unilateral breast reconstruction. After attempting to carry out breast reconstruction with latissimus dorsi, many surgeons constantly improved, designed, and modified multiple forms of operation programs and thus promote increasing improvement in repair and reconstruction of the breast after breast reduction surgery and mastectomy for breast cancer [1] Currently, breast reconstruction after breast cancer surgery is just in the early stage while it has occupied an important position in developed countries,therefore, the knowledge of breast reconstruction needs to be enhanced and publicized in our country. Some data show the quality of life in patients following breast reconstruction surgery is significantly higher than that in patients undergoing lumpectomy plus radiotherapy or simple mastectomy. More and more patients pursue breast reconstruction after mastectomy for breast cancer. Breast reconstruction is roughly divided into lost chest wall skin repair, hemispherical breast reconstruction, anterior axillary fold repair, plastic surgery for subclavian depression, nipple and areola reconstruction and asymmetrical breast repair. In the reconstruction of breasts, it is necessary to endeavor to make the rebuilt breast symmetrical to the healthy side so that future adjustment will be simple and easily feasible.

Stratification of Surgical Risk in DIEP Breast Reconstruction Based on Classification of Obesity

2021 ◽  
Author(s):  
Charles W. Patterson ◽  
Patrick A. Palines ◽  
Matthew J. Bartow ◽  
Daniel J. Womac ◽  
Jamie C. Zampell ◽  
...  
Keyword(s):  
Breast Reconstruction ◽  
Full Range ◽  
Donor Site ◽  
World Health ◽  
Morbidly Obese ◽  
Diep Flap ◽  
Obese Patients ◽  
Class Iii ◽  
Recipient Site ◽  
Surgical Risk

Abstract Background From both a medical and surgical perspective, obese breast cancer patients are considered to possess higher risk when undergoing autologous breast reconstruction relative to nonobese patients. However, few studies have evaluated the continuum of risk across the full range of obesity. This study sought to compare surgical risk between the three World Health Organization (WHO) classes of obesity in patients undergoing deep inferior epigastric perforator (DIEP) flap breast reconstruction. Methods A retrospective review of 219 obese patients receiving 306 individual DIEP flaps was performed. Subjects were stratified into WHO obesity classes I (body mass index [BMI]: 30–34), II (BMI: 35–39), and III (BMI: ≥ 40) and assessed for risk factors and postoperative donor and recipient site complications. Results When examined together, the rate of any complication between the three groups only trended toward significance (p = 0.07), and there were no significant differences among rates of specific individual complications. However, logistic regression analysis showed that class III obesity was an independent risk factor for both flap (odds ratio [OR]: 1.71, 95% confidence interval [CI]: 0.91–3.20, p = 0.03) and donor site (OR: 2.34, 95% CI: 1.09–5.05, p = 0.03) complications. Conclusion DIEP breast reconstruction in the obese patient is more complex for both the patient and the surgeon. Although not a contraindication to undergoing surgery, obese patients should be diligently counseled regarding potential complications and undergo preoperative optimization of health parameters. Morbidly obese (class III) patients should be approached with additional caution, and perhaps even delay major reconstruction until specific BMI goals are met.

Sign in / Sign up

Export Citation Format

Share Document