Dermal Autografts in Breast Reconstruction

Davis, Claire; Boyd, Carter J.; Andino, D.A. Mateo de Acosta; Kumbla, Pallavi A.; Sanchez, Ruston; Kurapati, Srikanth; T, King; Torre, Jorge I. de la

doi:10.1097/sap.0000000000002128

Cited by 9 publications

(5 citation statements)

References 10 publications

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“…Lower pole expander coverage selection was established either by the dermofat flap or the serratus facia based on the breast measurements of the patient according to the algorithm shown in Fig. (8). Moreover, the final closure was based on these measurements by either no vertical scar or inverted T scar.…”

Section: Resultsmentioning

confidence: 99%

Local Autologous Tissues for Expander Coverage in 1st Stage of Delayed-Immediate Breast Reconstruction: Economy-Directed Protocol Modification

Ali

Mahboub

Elsharkawy

2023

The Egyptian Journal of Plastic and Reconstructive Surgery

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Background: Increasing awareness of post-mastectomy reconstruction raises the demand of searching of many alternatives that can be applied to every patient who came for reconstruction. Completion of expander pocket in first-stage of delayed-immediate breast reconstruction was performed by many techniques. Aim:We propose an algorithm for this step that can be applied in our low-income country.Methods: Thirty-four patients fulfilling skin-sparing mastectomy criteria were enrolled in this study. Definite decision regarding postoperative radiotherapy was questionable. First stage of delayed-immediate reconstruction performed with insertion of expander at time of mastectomy. Regarding choice of completion of sub-muscular pocket of expander, the patients were divided into two groups according to the degree of ptosis: Group I (large ptotic breasts where in dermal flap was indicated), group II (small non ptotic breasts wherein total submuscular pocket indicated).Results: Dermal flap was performed on patients with large ptotic breasts, whereas subpectoral pocket completion was performed on patients with small non-ptotic breasts using the serratus fascia. Two algorithms were proposed to guide the surgeon during the selection of timing and the second one in choosing the most suitable technique. Early post-operative complications where minor and managed conservatively. Conclusion:Decisions regarding postmastectomy breast reconstruction are multifactorial. The factors not only include staging and perioperative adjuvant management but also include considerations regarding cost and availability of resources. Authors proposed an economically directed algorithm in the first stage of delayed-immediate reconstruction for selection of expander coverage.

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Section: Resultsmentioning

confidence: 99%

Local Autologous Tissues for Expander Coverage in 1st Stage of Delayed-Immediate Breast Reconstruction: Economy-Directed Protocol Modification

Ali

Mahboub

Elsharkawy

2023

The Egyptian Journal of Plastic and Reconstructive Surgery

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“…When compared with ADM, dermal autografts have been shown to increase neovascularization in multiple studies, which theoretically decreases complications. 10 To date (6-months postoperatively), the patient has had no further complications or symptoms of recurrence or infection.…”

Section: Discussionmentioning

confidence: 99%

Traumatic Abdominal Wall Hernia Repair with Dermal Autograft within a Morel-Lavallée Lesion

Mayan

Mujadzic

et al. 2022

Plastic and Reconstructive Surgery - Global Open

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Summary: Morel-Lavallée lesions and traumatic abdominal wall hernias seldom present together and have no standardized guidelines for treatment. We present a unique case of a traumatic abdominal wall hernia present within a patient’s abdominal Morel-Lavallée lesion, which was reduced and repaired with a dermal autograft. This is a novel approach to repairing a rare and unusual injury. The literature suggests that tension-free repairs with mesh should be used on delayed repairs of traumatic abdominal wall hernias. However, some advocate for primary repairs due to an up to 50% increased risk of wound infection in these injuries, even without the use of mesh. Although infection rates with the use of biologic mesh (acellular dermal matrices) in a contaminated field are lower than that of synthetic mesh, infections still occur and tend to be higher in repairs without mesh. The lack of foreign material and innate immunogenicity of the patient’s own dermis may theoretically decrease the risk of infection compared with other commercially-available and biologically-derived products. The patient is a 47-year-old woman who was in a motor vehicle accident with prolonged extrication time. She was hospitalized for approximately 6 months due to extensive injuries, but had no further complications from her Morel-Lavallée lesion or repair of her traumatic abdominal wall hernia with her own dermis.

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“…An alternative technique to synthetic supportive material is the use of autologous de-epithelialized dermal grafts, mostly harvested from the ipsilateral side from the lower pole of the breast skin. 25,26…”

Section: Complicationsmentioning

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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Dermal Autografts in Breast Reconstruction

Cited by 9 publications

References 10 publications

Local Autologous Tissues for Expander Coverage in 1st Stage of Delayed-Immediate Breast Reconstruction: Economy-Directed Protocol Modification

Local Autologous Tissues for Expander Coverage in 1st Stage of Delayed-Immediate Breast Reconstruction: Economy-Directed Protocol Modification

Traumatic Abdominal Wall Hernia Repair with Dermal Autograft within a Morel-Lavallée Lesion

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

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