Donor Site Morbidity and Patient Satisfaction Using a Composite Nipple Graft for Unilateral Nipple Reconstruction in the Radiated and Non-Radiated Breast

2010 ◽  
Vol 126 ◽  
pp. 26
Author(s):  
Scott L. Spear ◽  
Adam D. Schaffner ◽  
M. Renée Jespersen ◽  
Jesse A. Goldstein
Keyword(s):  
Patient Satisfaction ◽  
Donor Site ◽  
Donor Site Morbidity ◽  
Nipple Reconstruction

The Reverse Pedicle Heterodigital Cross-Finger Island Flap

1997 ◽  
Vol 22 (1) ◽  
pp. 25-29 ◽  
Author(s):  
G. GERMANN ◽  
S. RÜTSCHLE ◽  
N. KANIA ◽  
T. RAFF
Keyword(s):  
Patient Satisfaction ◽  
Donor Site ◽  
Donor Site Morbidity ◽  
Island Flap

The use of the reverse pedicle island flap as a heterodigital cross-finger flap is reported in five patients in whom conventional cross-finger flaps or homodigital flaps could not be used. All flaps survived and patient satisfaction was high. However, the indication for the flap must be considered carefully as the dissection is technically demanding and there is some donor site morbidity.

Analysis of patient satisfaction and donor-site morbidity after different types of breast reconstruction

2014 ◽  
Vol 103 (4) ◽  
pp. 249-255 ◽  
Author(s):  
H. C. Benditte-Klepetko ◽  
F. Lutgendorff ◽  
T. Kästenbauer ◽  
M. Deutinger ◽  
C. M. A. M. van der Horst
Keyword(s):  
Quality Of Life ◽  
Patient Satisfaction ◽  
Breast Reconstruction ◽  
Latissimus Dorsi ◽  
Donor Site ◽  
Perforator Flap ◽  
Donor Site Morbidity ◽  
Deep Inferior Epigastric Perforator ◽  
Types Of Breast Reconstruction

Background and Aims: Breast reconstruction has been shown to improve quality of life. However, factors involved in long-term patient satisfaction are largely unknown. Our aim was to evaluate patient satisfaction and donor-site morbidity in five types of breast reconstruction. Material and Methods: A prospectively collected database of all breast surgery patients at Hospital Rudolfstiftung, Vienna, Austria, was searched for five types of breast reconstruction (2000–2006): implant, latissimus dorsi-flap, latissimus dorsi-flap with implant, free transverse rectus abdominis musculocutaneous-flap, and deep inferior epigastric perforator-flap. Patients were sent a study-specific questionnaire to assess satisfaction. Short-form 36-item health survey was used to analyze (quality of life), and complication data were retrieved from the database and assessed during a follow-up visit. Results: There were 257 patients identified, of whom, 126 responded to the survey (17 implant, 5 latissimus dorsi + implant, 64 latissimus dorsi, 22 transverse rectus abdominis musculocutaneous, and 18 deep inferior epigastric perforator reconstructions). No statistical differences were found in complication or reoperation rates. Deep inferior epigastric perforator–flap patients were significantly more satisfied compared to patients from the implant group ( p = 0.007). However, there was no significant difference regarding quality of life scores among the groups. After logistic regression analysis, only “impairment on daily life” showed to be independently correlated with patient satisfaction. This contrary to both operation type and complication rate which did not correlate with patient satisfaction. Conclusions: Our results indicate that operation type, complication rate, and revision rate did not independently correlate with patient satisfaction. Therefore, to further improve patient satisfaction, future research should be focused on other pro-operative factors, for example, patient education, expectations, and personality characteristics.

scholarly journals One injection for a great projection: a quick and simple procedure for nipple reconstruction

2021 ◽  
Vol 48 (2) ◽  
pp. 179-184
Author(s):  
Sara Tanini ◽  
Sara Calabrese ◽  
Elena Lucattelli ◽  
Giulia Lo Russo
Keyword(s):  
Simple Procedure ◽  
Donor Site ◽  
Three Dimensional ◽  
Donor Site Morbidity ◽  
Single Step ◽  
Nipple Reconstruction ◽  
Breast Cancer Patients ◽  
Reconstruction Process ◽  
Areolar Complex ◽  
Wound Matrix

Women attach great importance to the presence of a three-dimensional nipple upon completion of the breast reconstruction process. To meet patients’ expectations, nipple-areolar complex reconstruction should achieve symmetry in position, size, shape, texture, and color, as well as minimizing donor-site morbidity. However, it is well known that regardless of the reconstructive technique, loss of nipple projection can be reasonably expected. We developed and evaluated a quick, simple, and innovative technique using injectable Integra Flowable Wound Matrix to increase nipple projection after reconstruction. Twenty breast cancer patients who underwent nipple reconstruction resulting in unsatisfactory projection were enrolled in our retrospective study. Nipple projection was measured at the time of surgery and after 6 and 12 months. A visual analogue scale was used to assess patients’ satisfaction. Our technique yielded reliable results in terms of the long-lasting maintenance of nipple projection. This method is high-priced, but cost-effective, since one kit may suffice for three patients. Furthermore, our patients were very appreciative of this technique as a single-step, minimally invasive, painless procedure with no reported necessity of re-intervention.

scholarly journals Nipple Reconstruction Techniques: Which is the Best Choice?

2018 ◽  
Vol 5 (1) ◽  
pp. 62-75 ◽  
Author(s):  
Nicolò Bertozzi ◽  
Francesco Simonacci ◽  
Marianna Pesce ◽  
PierLuigi Santi ◽  
Edoardo Raposio
Keyword(s):  
Donor Site ◽  
Donor Site Morbidity ◽  
Contralateral Side ◽  
Skin Thickness ◽  
Nipple Reconstruction ◽  
Areolar Complex ◽  
Long Term Follow Up ◽  
Case Basis

Nipple-Areolar Complex (NAC) reconstruction represents the final, concluding journey of breast reconstruction by being able to give to reconstructed breasts the shape of a natural breast mound. Nevertheless an enormous amount of nipple reconstruction techniques are described in literature, given the fact that most reconstructive options fail to give satisfactory outcomes in relation to the long-term nipple projection. In this review, the authors will browse most common nipple reconstruction techniques, taking into account: Indication, outcome, and side effect. Composite nipple grafts, traditional flaps, flaps with autologous graft augmentation, flaps with allograft augmentation, and flaps with alloplastic augmentation are the main strategies employed nowadays. Composite nipple grafts give the best guarantee of color-texture match with the contralateral side and show satisfactory nipple projection even at long-term follow-up. Skate, star, C-V, and arrow flap are by far the most commonly employed and the most reliable local flaps, however loss of projection of up to 70 percent are reported in literature. Alloplastic grafts were associated with the lowest rates of projection loss followed by autologous and allogenic ones. Nevertheless allogenic grafts are also associated with the highest complication rate, while autologous and allogenic ones have similar rates. Infection, seroma, and fat necrosis are the more commonly reported complications of autologous grafting along with donor site morbidity, while allogenic and alloplastic augmentation grafts may also experience the risk of overcorrection and graft exposure. Given the numerous techniques described in literature it is clear that the ideal nipple reconstruction hasn’t been found yet. Whereas it should be chosen on case to case basis depending on type of mastectomy, radiotherapy, type of reconstruction, skin thickness, tissue condition, and patients’ expectations to ensure the best cosmetic outcome.

scholarly journals Donor-site Morbidity after Retromolar Bone Harvesting Using a Standardised Press Fit Cylinder Protocol

Materials ◽  
2019 ◽  
Vol 12 (22) ◽  
pp. 3802
Author(s):  
Philipp Streckbein ◽  
Mathias Meier ◽  
Christopher Kähling ◽  
Jan-Falco Wilbrand ◽  
Tobias Langguth ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Surgical Treatment ◽  
Bone Graft ◽  
Healing Process ◽  
Donor Site ◽  
Bone Grafts ◽  
Donor Site Morbidity ◽  
Reconstruction Method ◽  
Transfer System ◽  
Recipient Site

Precise fitting and immobilisation of bone transplants at the recipient site is of utmost importance for the healing process. With the help of the standardised Osseo Transfer System, the recipient site is adjusted to the graft, rather than vice versa as it is typically done. The aim of this study was to analyse donor-site morbidity after harvesting cylindrical bone grafts from the retromolar region using the Osseo Transfer System. The patient satisfaction with the surgical procedures was also evaluated. All patients treated with this standardised reconstruction method between 2006 and 2013 at the Department of Cranio-Maxillofacial Surgery, University Hospital Giessen, were included in this study. Complications were recorded and evaluated. Bone graft success and patient satisfaction were documented with a questionnaire, and then confirmed by clinical and radiological follow-up examinations. Fifty-four patients were treated and 64 harvested cylindrical autologous bone grafts were transplanted. In all cases, dental implants could be inserted after bone healing. One patient lost an implant, associated with failure of the bone graft. Six patients who were examined continued to show neurological disorders in locally limited areas. No complete or long-term damage of the inferior alveolar nerve occurred. More than 94% (n = 52) of the patients were ‘very satisfied’ or ‘satisfied’ with the results and would recommend this surgical treatment to other patients. The standardised Osseo Transfer was an effective treatment option for small and mid-sized alveolar ridge augmentations. A low donor-site morbidity rate and a high transplant success rate were verified. The Osseo Transfer System demonstrated to be a reliable surgical technique without major complications. We highly recommend this surgical augmentation procedure as a surgical treatment for local bone defects.

scholarly journals Investigation Into the Optimal Number of Intercostal Nerve Transfers for Musculocutaneous Nerve Reinnervation: A Systematic Review

Hand ◽  
2017 ◽  
Vol 13 (6) ◽  
pp. 621-626 ◽  
Author(s):  
Hyuma A. Leland ◽  
Beina Azadgoli ◽  
Daniel J. Gould ◽  
Mitchel Seruya
Keyword(s):  
Systematic Review ◽  
Brachial Plexus ◽  
Donor Site ◽  
Elbow Flexion ◽  
Donor Site Morbidity ◽  
Intercostal Nerve ◽  
Optimal Number ◽  
Musculocutaneous Nerve ◽  
Nerve Transfers ◽  
Meta Analyses

Background: The purpose of this study was to systematically review outcomes following intercostal nerve (ICN) transfer for restoration of elbow flexion, with a focus on identifying the optimal number of nerve transfers. Methods: A systematic review was performed following Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines to identify studies describing ICN transfers to the musculocutaneous nerve (MCN) for traumatic brachial plexus injuries in patients 16 years or older. Demographics were recorded, including age, time to operation, and level of brachial plexus injury. Muscle strength was scored based upon the British Medical Research Council scale. Results: Twelve studies met inclusion criteria for a total of 196 patients. Either 2 (n = 113), 3 (n = 69), or 4 (n = 11) ICNs were transferred to the MCN in each patient. The groups were similar with regard to patient demographics. Elbow flexion ≥M3 was achieved in 71.3% (95% confidence interval [CI], 61.1%-79.7%) of patients with 2 ICNs, 67.7% (95% CI, 55.3%-78.0%) of patients with 3 ICNs, and 77.0% (95% CI, 44.9%-93.2%) of patients with 4 ICNs ( P = .79). Elbow flexion ≥M4 was achieved in 51.1% (95% CI, 37.4%-64.6%) of patients with 2 ICNs, 42.1% (95% CI, 29.5%-55.9%) of patients with 3 ICNs, and 48.4% (95% CI, 19.2%-78.8%) of patients with 4 ICNs ( P = .66). Conclusions: Previous reports have described 2.5 times increased morbidity with each additional ICN harvest. Based on the equivalent strength of elbow flexion irrespective of the number of nerves transferred, 2 ICNs are recommended to the MCN to avoid further donor-site morbidity.

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