The Impact of Two Operating Surgeons on Microsurgical Breast Reconstruction

2017 ◽  
Vol 139 (2) ◽  
pp. 277-284 ◽  
Author(s):  
Katie E. Weichman ◽  
Gretl Lam ◽  
Stelios C. Wilson ◽  
Jamie P. Levine ◽  
Robert J. Allen ◽  
...  
Keyword(s):  
Breast Reconstruction ◽  
The Impact

scholarly journals The Impact of the COVID-19 Pandemic on Breast Reconstruction: A Canadian Perspective

2021 ◽  
pp. 229255032110300
Author(s):  
Caroline F. Illmann ◽  
Christopher Doherty ◽  
Margaret Wheelock ◽  
Joshua Vorstenbosch ◽  
Joan E. Lipa ◽  
...  
Keyword(s):  
Breast Reconstruction ◽  
Care Delivery ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Web Based ◽  
Reconstructive Procedures ◽  
Surgical Access ◽  
Canadian Perspective ◽  
Canadian Provinces ◽  
The Impact

Background: The COVID-19 pandemic has led to unprecedented challenges and restrictions in surgical access across Canada, including for breast reconstructive services which are an integral component of comprehensive breast cancer care. We sought to determine how breast reconstructive services are being restricted, and what strategies may be employed to optimize the provision of breast reconstruction through a pan-Canadian evaluation from the providers’ perspective. Methods: This was a cross-sectional survey of Canadian plastic and reconstructive surgeons who perform breast reconstruction. The 33-item web-based questionnaire was developed by a pan-Canadian working group of breast reconstruction experts and disseminated via email to members of the Canadian Society of Plastic Surgery. The questionnaire queried respondents on the impact of the COVID-19 pandemic and associated restrictions on surgeons’ breast reconstruction practice patterns and opinions on strategies for resource utilization. Results: Responses were received from 49 surgeons, who reported practicing in 8 of 10 Canadian provinces. Restrictions on the provision of breast reconstructive procedures were most limited during the First Wave of the COVID-19 pandemic, where all respondents reported at least some reduction in capacity and more than a quarter reporting complete cessation. Average reported reduction in capacity ranged from 31% to 78% across all 3 waves. Autologous, delayed, and prophylactic reconstructions were most commonly restricted. Conclusion: This study provides a pan-Canadian impact assessment on breast reconstructive services during the COVID-19 pandemic from the providers’ perspective. To uphold the standards of patient-centred care, a unified approach to strategically reorganize health care delivery now and in the future is needed.

scholarly journals Use of Closed Incision Negative Pressure Therapy (ciNPT) in Breast Reconstruction Abdominal Free Flap Donor Sites

2021 ◽  
Vol 10 (21) ◽  
pp. 5176
Author(s):  
Jennifer Wang ◽  
Zyg Chapman ◽  
Emma Cole ◽  
Satomi Koide ◽  
Eldon Mah ◽  
...  
Keyword(s):  
Breast Reconstruction ◽  
Free Flap ◽  
Negative Pressure ◽  
Statistical Significance ◽  
Future Research ◽  
Wound Complications ◽  
Negative Pressure Therapy ◽  
Royal Melbourne Hospital ◽  
Pressure Therapy ◽  
The Impact

Background: Closed incision negative pressure therapy (ciNPT) may reduce the rate of wound complications and promote healing of the incisional site. We report our experience with this dressing in breast reconstruction patients with abdominal free flap donor sites. Methods: A retrospective cohort study was conducted of all patients who underwent breast reconstruction using abdominal free flaps (DIEP, MS-TRAM) at a single institution (Royal Melbourne Hospital, Victoria) between 2016 and 2021. Results: 126 female patients (mean age: 50 ± 10 years) were analysed, with 41 and 85 patients in the ciNPT (Prevena) and non-ciNPT (Comfeel) groups, respectively. There were reduced wound complications in almost all outcomes measured in the ciNPT group compared with the non-ciNPT group; however, none reached statistical significance. The ciNPT group demonstrated a lower prevalence of surgical site infections (9.8% vs. 11.8%), wound dehiscence (4.9% vs. 12.9%), wound necrosis (0% vs. 2.4%), and major complication requiring readmission (2.4% vs. 7.1%). Conclusion: The use of ciNPT for abdominal donor sites in breast reconstruction patients with risk factors for poor wound healing may reduce wound complications compared with standard adhesive dressings; however, large scale, randomised controlled trials are needed to confirm these observations. Investigation of the impact of ciNPT patients in comparison with conventional dressings, in cohorts with equivocal risk profiles, remains a focus for future research.

scholarly journals Evaluation of women’s quality of life after breast reconstruction surgery

2020 ◽  
Vol 66 (2) ◽  
Author(s):  
Marta Stanisz ◽  
Ewelina Kolak ◽  
Dorota Branecka-Woźniak ◽  
Renata Robaszkiewicz-Boukaz ◽  
Przemysław Ciepiela ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Breast Reconstruction ◽  
Great Influence ◽  
Well Being ◽  
World Health ◽  
World Health Organization Quality ◽  
Reconstruction Surgery ◽  
The Impact

Introduction: Breast cancer is the most common malignancy among women, and is usually treated surgically. Mastectomy has a great influence on the mental and physical condition of women. Breast reconstruction offers them a chance to improve their quality of life (QOL) and self-image.The main aim of the study was to gain knowledge about the impact of breast reconstruction on the QOL of women following mastectomy, and an analysis of the QOL after breast reconstruction, in the context of prosthesis effect assessment.Materials and methods: The study comprised 100 women following breast reconstructive surgery involved in 1 of the 7 “Amazon Clubs” (post-mastectomy women’s associations) in the West Pomeranian Voivodeship, northwest Poland. The study was based on the author’s questionnaire, and a shortened standardized version of the World Health Organization Quality of Life-BREF (WHOQOL-BREF) questionnaire. Statistical calculations were performed with StatSoft Statistica v10 software, adopting a significance level of p < 0.05.Results: The women who decided to have breast reconstruction surgery, noticed improved well-being (67%) and experiencedan increase in self-confidence (61%). The vast majority ofthe patients surveyed (93%) were satisfied with the effectof the prosthesis. Statistically significant differences in QOL were observed in the following spheres: rest and sleep, work capacity, negative feelings, and financial resources (p < 0.05) in relation to the evaluation of the prosthesis effect.Conclusions: 1. Breast reconstruction has a positive influence on improvements in well-being, increasing self-esteem, and the assessment of a more attractive appearance in women of all ages. 2. Breast reconstruction surgery has a positive impact on QOL and health in the physical, psychological, and environmental domains, especially in the women who are satisfied with the effects of the surgery. 3. A negative assessment of the breast reconstruction effect has an adverse influence on QOL. Identifying the factors affecting dissatisfaction with the post-operative outcome is crucial for a complete understanding of the subject, and for implementing measures aimed at improving the QOL of these women.Keywords: quality of life; mastectomy; breast cancer; breast reconstruction; breast surgery.

scholarly journals BMI Specific Complications Following Implant-Based Breast Reconstruction after Mastectomy

2021 ◽  
Vol 10 (23) ◽  
pp. 5665
Author(s):  
Helena Sophie Leitner ◽  
Reinhard Pauzenberger ◽  
Ines Ana Ederer ◽  
Christine Radtke ◽  
Stefan Hacker
Keyword(s):  
Postoperative Complications ◽  
Breast Reconstruction ◽  
Positive Impact ◽  
Surgical Techniques ◽  
Study Cohort ◽  
Complication Rates ◽  
Impaired Wound Healing ◽  
Reconstruction Methods ◽  
Study Results ◽  
The Impact

Background: Breast reconstruction has a positive impact on body image and quality of life for women after experiencing the physically and psychologically demanding process of mastectomy. Previous studies have presented body mass index (BMI) as a predictor for postoperative complications after breast reconstruction, however, study results vary. This retrospective study aimed to investigate the impact of patients’ BMI on postoperative complications following implant-based breast reconstruction. Methods: All implant-based breast reconstructions performed at the Department of Plastic, Reconstructive and Aesthetic Surgery at the Medical University of Vienna from January 2001 to March 2018 were evaluated. A total of 196 reconstructed breasts among 134 patients met eligibility criteria. Demographic data, surgical techniques, as well as major and minor complications within a one-year follow-up period were analyzed. Results: Patients’ BMI did not show a significant impact on complication rates. The overall incidence of postoperative complications was 30.5% (40/131) of which 17.6% required reoperation. Impaired wound healing (18.3%), seroma (6.1%), hematoma (4.6%), capsular contraction (4.6%) and infection (3.8%) were the most common complications. Conclusion: In our study cohort, BMI was not associated with a significantly higher risk of complications. However, postoperative complications significantly increased with a longer operative time and resulted in an extended length of hospital stay.

scholarly journals The Impact of Perforator Number on Deep Inferior Epigastric Perforator Flap Breast Reconstruction

2014 ◽  
Vol 41 (1) ◽  
pp. 63 ◽  
Author(s):  
Ritwik Grover ◽  
Jonas A Nelson ◽  
John P Fischer ◽  
Stephen J Kovach ◽  
Joseph M Serletti ◽  
...  
Keyword(s):  
Breast Reconstruction ◽  
Perforator Flap ◽  
Deep Inferior Epigastric Perforator ◽  
The Impact

scholarly journals Patient-Reported Satisfaction Following Radiation of Implant-Based Breast Reconstruction

2019 ◽  
Vol 27 (2) ◽  
pp. 147-155 ◽  
Author(s):  
Eva Thiboutot ◽  
Peter Craighead ◽  
Carmen Webb ◽  
Claire Temple-Oberle
Keyword(s):  
Breast Reconstruction ◽  
Capsular Contracture ◽  
Control Group ◽  
Arm Morbidity ◽  
Patient Reported ◽  
Cosmetic Outcomes ◽  
Baseline Characteristics ◽  
Pro Tools ◽  
Tumour Characteristics ◽  
The Impact

Background: Little is known with regard to patient-reported outcomes (PROs) in the setting of implant-based reconstruction (IBR) with post-mastectomy radiation therapy (PMRT). Methods: We identified patients who underwent immediate IBR from a prospectively compiled database. The Breast Reconstruction Satisfaction Questionnaire (BRECON-31) was scored and compared between patients with and without PMRT. Results: Sixty-four women met the study criteria. Forty-eight did not receive PMRT and 16 did. Nine women had an unanticipated indication for PMRT. The PMRT group was similar to the control group with regard to baseline characteristics (ie, age, marital status, body mass index, tobacco use, and comorbidities). However, treatment and oncologic characteristics (eg, diagnosis, tumour characteristics, systemic therapy use) differed. Of all complications, only capsular contracture rates differed (1.2% vs 13%; P = .01). Of the 9 subscales, 7 showed no difference in satisfaction between the groups. Radiated women scored lower in the arm concerns and breast appearance subscales. Scores were similar whether the indication for PMRT had been anticipated or not. Discussion: Women with immediate IBR scored similarly to their nonradiated counterparts across 7 of 9 domains of satisfaction. Arm concerns and breast appearance scores are lower with PMRT, likely secondarily to more extensive nodal procedures in higher stage patients and to the side effect profile of radiotherapy. Our findings are in line with the few available studies using other PRO tools to evaluate the impact of PMRT on patient satisfaction and studies objectively measuring the effect of PMRT on arm morbidity and cosmetic outcomes.

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