Comprehensive Outcome and Cost Analysis of Free Tissue Transfer for Breast Reconstruction

Abstract

Risk, III.

Complications Following Abdominal-Based Free Flap Breast Reconstruction: Is a 30 days Complication Rate Representative?

“…Fischer et al, in 2013, found that autologous reconstructions, flap type, anemia, ASA physical status C 3, obesity, and active smoking were associated with higher surgical complications during the first 30 days post-immediate reconstruction [15][16][17]. Obesity, chronic obstructive pulmonary disease, and hypertension were associated with major delayed surgical complications [15]. Mioton et al, in 2013, found that autologous reconstruction, when compared to prosthetic reconstruction, had higher rates of 30-day overall complications, wound infection, prosthesis/flap failure, and reoperation [18].…”

“…Fischer et al, in 2013, found that autologous reconstructions, flap type, anemia, ASA physical status C 3, obesity, and active smoking were associated with higher surgical complications during the first 30 days post-immediate reconstruction [15][16][17]. Obesity, chronic obstructive pulmonary disease, and hypertension were associated with major delayed surgical complications [15].…”

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

“…Some studies evaluating immediate autologous tissue-based reconstruction before PMRT have reported reasonable rates of complications and satisfactory cosmetic outcomes. 6,29,30,38 However, overall complication rates are often imprecisely defined, as reported overall complications may include complications at both the donor and recipient sites. 39 Even overall complication rates for only the recipient site are not significantly affected by PMRT, especially since radiation therapy is not typically begun until 1 or 2 months after the transfer of the microvascular flap.…”

Perioperative Optimization of Autologous Breast Reconstruction

“…However, muscle-conserving abdominal flaps may have an advantage in reducing morbidity. [17][18][19][20][21][22] The main findings of the present prospective study are that 15 of 16 patients (94 percent) were discharged from the hospital within 72 hours of surgery. Only the use of suction drains and the need for flap monitoring prevented patients from being discharged by the afternoon of the second postoperative day.…”