scholarly journals A Clinical Case of Breast Reconstruction with Greater Omentum Flap for Treatment of Upper Extremity Lymphedema

2019 ◽  
pp. 1
Author(s):  
Mikhail Y. Sinelnikov ◽  
Kuo Chen ◽  
Natalia S. Sukorceva ◽  
Mu Lan ◽  
Igor I. Bikov ◽  
...  
Keyword(s):  
Breast Reconstruction ◽  
Upper Extremity ◽  
Clinical Case ◽  
Greater Omentum ◽  
Omentum Flap

scholarly journals Breast reconstruction with the omentum flap: a case report with unsatisfactory outcome and review of the literature

2019 ◽  
Vol 52 (3) ◽  
pp. 105-109
Author(s):  
Rossella Spinelli ◽  
Monika Lanthaler ◽  
Christoph Tasch ◽  
Agnese Nitto ◽  
Gerhard Pierer ◽  
...  
Keyword(s):  
Breast Reconstruction ◽  
Severe Infection ◽  
Greater Omentum ◽  
Complication Rates ◽  
Local Hospital ◽  
Postoperative Results ◽  
Negative Experience ◽  
Case Presentation ◽  
Omentum Flap ◽  
Intraoperative Revision

Summary Background Recently, breast reconstruction with the greater omentum flap has gained more attention, although it has been only rarely reported in the literature. An unpleasant case presented by us here prompted us to perform a literature search on breast reconstruction with the omentum flap concerning postoperative results and complication rates. Case presentation We here present the case of a 46-year-old woman who presented with severe infection 3 months after omentum flap reconstruction in a distant local hospital. Intraoperative revision showed an inflammatory, completely necrotic flap that had to be removed. Conclusion The literature review shows that the omentum flap can be reasonably used only in one-sided reconstructions of very small breasts. Due to the limited indications, unpredictable flap volume, and our negative experience, we recommend that this type of reconstruction be used with restraint.

Postoperative Upper Extremity Function in Implant and Autologous Breast Reconstruction

2019 ◽  
Vol 36 (02) ◽  
pp. 151-156
Author(s):  
Brandon Alba ◽  
Benjamin Schultz ◽  
Lei Alexander Qin ◽  
Danielle Cohen ◽  
Matthew DelMauro ◽  
...  
Keyword(s):  
Lymph Node ◽  
Breast Reconstruction ◽  
Upper Extremity ◽  
Perforator Flap ◽  
Reconstruction Technique ◽  
Axillary Lymph ◽  
Arm Pain ◽  
Shoulder Range Of Motion ◽  
Extremity Function ◽  
Upper Extremity Function

Abstract Background After mastectomy and breast reconstruction, many patients experience upper extremity complications, such as pain, restriction in motion, and lymphedema. Despite an aesthetically satisfactory outcome, these occurrences can diminish a patient's postoperative quality of life. Several studies have investigated the causes and incidence of these complications. However, there is currently a paucity of data comparing postoperative upper extremity function according to reconstruction technique. Methods A review was performed of patients enrolled in a physical therapy (PT) program after mastectomy and immediate breast reconstruction. PT initial encounter evaluations were used to gather data on patients' postoperative upper extremity function. Hospital records were used to gather surgical and demographic data. For each patient, data were collected for each upper extremity that was ipsilateral to a reconstructed breast. Data were then compared between patients who underwent implant-based versus autologous deep inferior epigastric perforator flap reconstruction. Results A total of 72 patients were identified, including 39 autologous and 33 implant-based reconstruction cases. Proportions of patients who underwent sentinel lymph node biopsies and axillary lymph node dissections were similar between the two groups. The autologous-based reconstruction patients had significantly higher arm pain at rest (p = 0.004) and with activity (p = 0.031) compared with implant patients. Shoulder range of motion and manual muscle test results were similar between groups, with the exception of elbow flexion, which was weaker in implant patients (p = 0.030). Implant patients were also more likely to report “severe difficulty” or “inability” to perform activities of daily living (p = 0.022). Edema/swelling, axillary cording, and lymphedema girth measurements were similar between the two groups. Conclusion Different techniques of breast reconstruction can result in different postoperative upper extremity complications. These data show specific areas where postoperative care and PT can be customized according to reconstruction type. Investigation is currently underway to determine the effect of PT on upper extremity function in these patients.

Upper Extremity Anomalies

2019 ◽  
pp. 203-210
Author(s):  
Robin D. Clark ◽  
Cynthia J. Curry
Keyword(s):  
Valproic Acid ◽  
Differential Diagnosis ◽  
Upper Extremity ◽  
Clinical Case ◽  
Background Information ◽  
Amniotic Band ◽  
Case Presentation ◽  
Vascular Disruption ◽  
Common Causes ◽  
Malformation Syndromes

This chapter reviews background information about the incidence, epidemiology, genetics, and other anomalies associated with common congenital anomalies of the upper extremity. The discussion reviews the differential diagnosis of transverse, longitudinal (amelia, radial, ulnar), intercalary (phocomelia), and central (split hand/foot) defects of the radius and ulna and combined upper and lower extremity defects. The chapter summarizes common causes of upper extremity anomalies, including amniotic band disruption sequence, teratogenic agents (misoprostol, thalidomide, valproic acid), vascular disruption, chromosome anomalies, and Mendelian congenital malformation syndromes, and it gives recommendations for evaluation and management. A clinical case presentation features an infant with Holt–Oram syndrome.

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