Abstract 51

Sanati-Mehrizy, Paymon; Massenburg, Benjamin B.; Rozehnal, John; Ingargiola, Michael J.; Hernandez-Rosa, Jonatan; Taub, Peter J.

doi:10.1097/01.prs.0000465499.07154.c2

Cited by 2 publications

(2 citation statements)

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“…12 17 18 19 20 One study utilizing the ACS NSQIP database from 2005 to 2012 concluded that delayed modalities including the use of a prosthesis and autologous reconstruction were associated with increased postoperative medical and surgical complications. 21 While these results are in contrast to our findings, our study captures an updated cohort from 2010 to 2020 and may reflect current trends in postoperative complications between each reconstructive timing modality in free flap reconstruction.…”

Section: Discussioncontrasting

confidence: 99%

A Comparison of Postoperative Outcomes Between Immediate, Delayed Immediate, and Delayed Autologous Free Flap Breast Reconstruction: Analysis of 2010–2020 NSQIP Data

Marquez

Sudduth

Kuo

et al. 2023

J Reconstr Microsurg

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Introduction While many factors influence decisions related to the timing between mastectomy and flap-based breast reconstruction, there is limited literature comparing postoperative complications between immediate (IBR), delayed immediate (DIBR), and delayed (DBR) reconstruction modalities. Using the National Surgical Quality Improvement Program (NSQIP), we sought to compare postoperative complication rates of each timing modality. Methods The NSQIP 2010-2020 database was queried for patients who underwent free flap breast reconstruction. Cases were categorized to include mastectomy performed concurrently with a free flap reconstruction, removal of a tissue expander with free flap reconstruction, and free flap reconstruction alone which are defined as IBR, DIBR, and DBR, respectively. The frequency of postoperative outcomes including surgical site infection (SSI), wound dehiscence, intraoperative transfusion, deep venous thrombosis (DVT), and return to operating room (OR) were assessed. Overall complication rates, hospital length of stay (LOS), and operative time were analyzed. Multivariable regression analysis controlling for age, race, BMI, diabetes, hypertension, ASA class, and laterality was performed. Results A total of 7907 cases that underwent IBR, DIBR (n=976), and DBR reconstruction (n=6713) were identified. No statistical difference in occurrence of SSI’s, wound dehiscence, or DVT were identified. DIBR (9%) and DBR (11.9%) were associated with less occurrences of reoperation than IBR (13.2%, p<0.001). Univariate and multivariate regression analysis demonstrated that DIBR and DBR were associated with a lower odds of complications and shorter operation time versus IBR. No statistically significant differences between DIBR and DBR in surgical complications, LOS, and operative time were identified. Conclusion Awareness of overall complication rates associated with each reconstructive timing modality can be used to help guide physicians when discussing reconstructive options. Our data suggests that DIBR and DBR are associated with less overall complications than IBR. Physicians should continue to consider patients’ unique circumstances when deciding upon which timing modality is appropriate.

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Section: Discussioncontrasting

confidence: 99%

A Comparison of Postoperative Outcomes Between Immediate, Delayed Immediate, and Delayed Autologous Free Flap Breast Reconstruction: Analysis of 2010–2020 NSQIP Data

Marquez

Sudduth

Kuo

et al. 2023

J Reconstr Microsurg

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“…2,3 Although the rates of major complications after immediate reconstruction (at the same time as mastectomy) are greater than after mastectomy alone, clinically significant delays in the receipt of adjuvant therapy after immediate reconstruction have not been found. 4,5 Breast reconstruction after mastectomy has evolved over the last century to be an integral component in the therapy for patients with breast cancer. Breast reconstruction originally was designed to reduce post mastectomy complications and to correct chest wall deformity, but its value has been recognized to extend past this limited view of use.…”

Section: Introductionmentioning

confidence: 99%

Study of options and procedures in reconstruction of post mastectomy breast defects in a regional cancer centre

Palukuri,

Kathi,

Pawde

et al. 2023

Int Surg J

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Background: Post mastectomy autologous breast reconstruction is challenging and involves restoring the patients lost structure and prepping the patient for adjuvant therapy and also psychosocial benefits that comes with early breast reconstruction. We analysed latissimus dorsi flap, transverse rectus abdomenis flap, deep inferior epigastric perforator flap and thoracoabdominal flap. Aim was to reconstruct post mastectomy defect using various methods, to enable the patient to receive early adjuvant therapy. Objectives were to study the various procedures used for post mastectomy defect autologous breast reconstruction. To evaluate the reliability of various flaps used. To evaluate the complications of flaps and their management. To assess the advantages and disadvantages of each flap. Methods: 42 post mastectomy defect patients reconstructed with 4 flaps over 24 months, included in the study and results analysed. Results: In 42 cases, latissimus dorsi flap was done in 11 cases, transverse rectus abdominis flap was done in 6 cases, deep inferior epigastric perforator flap was done in 3 cases and thoracoabdominal flap was done in 22 cases. Total flap loss in 1 case and partial flap loss in 6 cases was seen. Conclusions: Immediate autologous breast reconstruction is helpful in making the patient ready for upcoming adjuvant therapy along with psychosocial benefits. We have analysed 4 different types of flaps and compared their advantages and disadvantages. We found that thoracoabdominal flap is a good option of immediate coverage in low socioeconomic class patients and ones with terminal disease.

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Abstract 51

Cited by 2 publications

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A Comparison of Postoperative Outcomes Between Immediate, Delayed Immediate, and Delayed Autologous Free Flap Breast Reconstruction: Analysis of 2010–2020 NSQIP Data

A Comparison of Postoperative Outcomes Between Immediate, Delayed Immediate, and Delayed Autologous Free Flap Breast Reconstruction: Analysis of 2010–2020 NSQIP Data

Study of options and procedures in reconstruction of post mastectomy breast defects in a regional cancer centre

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