Donor site morbidity following DIEP flap for breast reconstruction in Asian patients: Is it different?

Paik, Joo Myong; Lee, Kyeong‐Tae; Jeon, Byung-Joon; Lim, So-Young; Pyon, Jai‐Kyong; Bang, Sa Ik; Oh, Kap Sung; Mun, Goo‐Hyun

doi:10.1002/micr.22495

Cited by 23 publications

(29 citation statements)

References 45 publications

(101 reference statements)

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“…Previous studies have shown that patient comorbidities such as smoking, radiated-recipient vessel, and diabetes are significant risk factors for postoperative complications. 8,12,13 Our study demonstrates that it is possible to maximize resident operative experience without compromising patient safety in advanced, complex surgical cases. The factors that lead to these results include the availability of microsurgical education material, animal labs for skills improvement, large microsurgical clinical volume, availability and dedication of the faculty to teaching, and commitment to assuring resident independence at each level of training with appropriate supervision.…”

Section: Discussionmentioning

confidence: 73%

Achieving balance between resident autonomy and patient safety: Analysis of resident-led microvascular reconstruction outcomes at a microsurgical training center with an established microsurgical training pathway

Cho

Halani

Davis

et al. 2020

Journal of Plastic, Reconstructive & Aesthetic Surgery

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Section: Discussionmentioning

confidence: 73%

Achieving balance between resident autonomy and patient safety: Analysis of resident-led microvascular reconstruction outcomes at a microsurgical training center with an established microsurgical training pathway

Cho

Halani

Davis

et al. 2020

Journal of Plastic, Reconstructive & Aesthetic Surgery

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“…Korean women are generally considered to be thinner than women in other populations, and consequently have a small abdomen [ 9 ]. The mean BMI of the patients in our study was 23.55 kg/m 2 , which may be considered unusual from the standpoint of Western physicians who might think that Koreans are not good candidates for breast reconstruction with an abdominal flap [ 18 ].…”

Section: Discussionmentioning

confidence: 99%

Weight analysis of mastectomy specimens and abdominal flaps used for breast reconstruction in Koreans

et al. 2018

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BackgroundSlim patients or those with large breasts may be ineligible for breast reconstruction with an abdominal flap, as the volume of the flap may be insufficient. This study aimed to establish that abdominal tissue–based breast reconstruction can be well suited for Korean patients, despite their thin body habitus.MethodsA total of 252 patients who underwent postmastectomy breast reconstruction with an abdominal flap from October 2006 to May 2013 were retrospectively reviewed. The patients’ age and body mass index were analyzed, and a correlation analysis was performed between the weight of the mastectomy specimen and that of the initial abdominal flap.ResultsThe average weights of the mastectomy specimen and initial abdominal flap were 451.03 g and 644.95 g, respectively. The ratio of the weight of the mastectomy specimen to that of the initial flap was 0.71±0.23. There was a strong positive linear relationship between the weight of the mastectomy specimen and that of the initial flap (Pearson correlation coefficient, 0.728). Thirty nulliparous patients had a final-to-initial flap weight ratio of 0.66±0.11. The 25 patients who underwent a contralateral procedure had a ratio of 0.96±0.30. The adjusted ratio of the final flap weight to the initial flap weight was 0.66±0.12.ConclusionsBreast weight had a strong positive relationship with abdominal flap weight in Koreans. Abdominal flaps provided sufficient soft tissue for breast reconstruction in most Korean patients, including nulliparous patients. However, when the mastectomy weight is estimated to be >700 g, a contralateral reduction procedure may be considered.

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“…Previous reports showed that the incidence of abdominal complications after autologous reconstruction was ranged from 3.4 to 25.8%. Some reports considered that a higher BMI was associated with higher morbidity in abdominal complications [ 5 – 7 , 11 ]. However, the bulging and herniation of the donor site is rare in previous reports.…”

Section: Discussionmentioning

confidence: 99%

Spontaneous rupture of abdominal wall after breast reconstruction using deep inferior epigastric perforator flap following mastectomy for breast cancer

Iwabu¹,

Namikawa²,

Kitagawa³

et al. 2018

surg case rep

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BackgroundThe demand for breast reconstruction after mastectomy is rising. The use of deep inferior epigastric perforator (DIEP) flap in autologous reconstruction is a popular approach. There were some reports about abdominal complications after breast reconstruction. However, there was no report about spontaneous rupture of abdominal wall.Case presentationA 46-year-old female patient was diagnosed with left breast cancer. Left mastectomy with sentinel lymph node biopsy was performed, and the breast was reconstructed using DIEP flap simultaneously. She suffered heavy abdominal pain and vomiting at postoperative day 4. Computed tomography showed bowel herniation into the subcutaneous tissue caused by left abdominal wall rupture. The abdominal wall was sutured and repaired using mesh by emergency surgery.ConclusionsTo the best of our knowledge, this is the first case about spontaneous rupture of abdominal wall after breast reconstruction using DIEP flap to be reported in the English literature. DIEP flap on breast reconstructive surgery may cause spontaneous rupture of abdominal wall.

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Donor site morbidity following DIEP flap for breast reconstruction in Asian patients: Is it different?

Abstract: DIEP flap breast reconstruction performed in Asian patients showed acceptable donor-site morbidity without significant complications. This study suggests that donor-site morbidity from harvesting a DIEP flap is comparable to that described in Western literatures.

Cited by 23 publications

References 45 publications

Achieving balance between resident autonomy and patient safety: Analysis of resident-led microvascular reconstruction outcomes at a microsurgical training center with an established microsurgical training pathway

Achieving balance between resident autonomy and patient safety: Analysis of resident-led microvascular reconstruction outcomes at a microsurgical training center with an established microsurgical training pathway

Weight analysis of mastectomy specimens and abdominal flaps used for breast reconstruction in Koreans

Spontaneous rupture of abdominal wall after breast reconstruction using deep inferior epigastric perforator flap following mastectomy for breast cancer

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