The purpose of this article is to comprehensively review the topic of local flaps. Local flaps are those that are elevated nearby and then transferred to an adjacent wound. Options include geometric local flaps, axial pattern local flaps and a new exciting group of flaps, local perforator flaps. The principles, advantages, disadvantages, and applications for each are carefully analyzed. Local perforator flaps can be harvested virtually anywhere in the body and represent a significant clinical advance, as these can solve a wide variety of clinical challenges. These flaps do require gentle microsurgical dissection technique with careful handling for inset of the flap and simultaneously provide the same advantages of other types of local flaps because they also use nearby tissues with a similar color match, thickness, and texture, with primary donor-site closure possible. Local perforator flaps are another very useful option that undoubtedly will become more popular as more surgeons become more familiar with their use and advantages.
Introduction: Breast cancer is the most common invasive neoplasm in women. When taken to mastectomy, breast reconstruction is an integral part of treatment. Objectives: The purpose of this study is to determine which factors are associated to post-operatory complications of breast reconstruction in patients with breast cancer treated with mastectomy. Methods: 306 patients taken to breast reconstruction were divided into three groups depending on technique: pedicled flaps, prosthetic material and deep inferior epigastric perforators (DIEP). Descriptive and comparative statistics were performed to find associations between the type of reconstruction and complications. Results: The factors associated to general were bleeding and reintervention. Reintervention was associated to loss of reconstruction. Factors associated to reoperation were immediate complications, late complications, and radiotherapy. Factors associated to loss of reconstruction where smoker status, presence of late complications, and reintervention. Conclusion: There is a higher percentage of immediate complications and loss of reconstruction with prosthetics. DIEP is an alternative with lower probability of loss of reconstruction. Multidisciplinary teams should establish the decision of the best type of reconstruction.
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