Abstract 1

BACKGROUND Radiation to free flaps following immediate breast reconstruction has been shown to compromise outcomes. We hypothesized that irradiated muscle-sparing free transverse rectus abdominis musculocutaneous (MS FTRAM) flaps experience less fat necrosis than irradiated deep inferior epigastric perforator (DIEP) flaps. METHODS We performed a retrospective study of all consecutive patients undergoing immediate, autologous, abdominal-based free flap breast reconstruction with MS FTRAM or DIEP flaps over a 10-year period at The University of Texas MD Anderson Cancer Center. Irradiated flaps (external-beam radiation therapy) after immediate breast reconstruction were compared to non-irradiated flaps. Logistic regression analysis was used to identify potential associations between patient, tumor, and reconstructive characteristics and surgical outcomes. RESULTS A total of 625 flaps were included in the analysis: 40 (6.4%) irradiated vs. 585 (93.6%) non-irradiated. Mean follow-up for the irradiated vs. non-irradiated flaps was 60.0 months and 48.5 months, respectively (p=0.02). Overall complication rates were similar for both the irradiated and non-irradiated flaps. Irradiated flaps (i.e., both DIEP and MS FTRAM flaps) developed fat necrosis at a significantly higher rate (22.5%) than the non-irradiated flaps (9.2%; p=0.009). There were no differences in fat necrosis rates between the DIEP and MS FTRAM flaps in both the irradiated and non-irradiated groups. CONCLUSIONS Both DIEP and MS FTRAM flap reconstructions had much higher rates of fat necrosis when irradiated. Contrary to our hypothesis, we found that immediate breast reconstruction with an MS FTRAM flap does not result in a lower rate of fat necrosis than reconstruction with a DIEP flap.

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Myth-Busting the DIEP Flap and an Introduction to the Abdominal Perforator Exchange (APEX) Breast Reconstruction Technique: A Single-Surgeon Retrospective Review

DellaCroce

Blum

et al. 2019

Plastic &Amp; Reconstructive Surgery

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Abstract 1

Cited by 3 publications

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Muscle-Sparing TRAM Flap Does Not Protect Breast Reconstruction from Postmastectomy Radiation Damage Compared with the DIEP Flap

Muscle-Sparing TRAM Flap Does Not Protect Breast Reconstruction from Postmastectomy Radiation Damage Compared with the DIEP Flap

Muscle-Sparing TRAM Flap Does Not Protect Breast Reconstruction from Postmastectomy Radiation Damage Compared with the DIEP Flap

Myth-Busting the DIEP Flap and an Introduction to the Abdominal Perforator Exchange (APEX) Breast Reconstruction Technique: A Single-Surgeon Retrospective Review

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