Donor-Site Morbidity following Harvest of the Transverse Myocutaneous Gracilis Flap for Breast Reconstruction

Craggs, Barbara; Vanmierlo, Bert; Zeltzer, Assaf; Buyl, Ronald; Haentjens, Patrick; Hamdi, Moustapha

doi:10.1097/prs.0000000000000612

Cited by 47 publications

(83 citation statements)

References 17 publications

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“…In this manuscript, the donor-site complications noted were wound breakdown and hypertrophic scar (4.8%), infection (2.2%), seroma (2.4%), and hematoma (0.7%). 18 In the literature, paresthesia and dysesthesia are common lateral thigh complications; however, rates of these complications are not routinely reported in our clinical notes and, therefore, cannot be addressed in the present study. Our overall complication rate for lateral thigh flaps was 21.3%, with the most common complication being dehiscence (11.2%).…”

Section: Discussionmentioning

confidence: 91%

“…Several other studies have noted a significant incidence of donor-site paresthesias with lateral thigh donor sites; however, this complication is not routinely assessed at our center, thereby prohibiting any commentary on its incidence here. 5,6,18,19 Analysis of donor-site esthetics, including pathologic scarring and pigmentation, was also not included in this study. Additionally, we do not routinely perform preoperative and postoperative strength testing of the lower extremity after thigh flap harvest.…”

Section: Discussionmentioning

confidence: 99%

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Donor-site Morbidity of Medial and Lateral Thigh-based Flaps: A Comparative Study

Purnell

Lewis

Mioton³

et al. 2016

Plastic and Reconstructive Surgery - Global Open

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Background:Free and pedicled medial and lateral thigh-based flaps are common reconstructive procedures. However, there have been no comparative studies of morbidity between medial and lateral donor sites.Methods:We conducted an Enterprise Data Warehouse-based review of all the senior authors’ (R.D.G., G.A.D., and M.S.A.) thigh-based free and pedicled flaps. Patient demographic data, donor-site complications, drain duration, and number of postoperative visits were collected and compared. Complications were also compared between fasciocutaneous flaps and muscle or myocutaneous flaps, and skin grafted donor sites.Results:We analyzed 352 flap donor sites, with 155 medial and 197 lateral. Two hundred seventeen (217) flaps were pedicled. Flap types included 127 gracilis, 27 rectus femoris, 134 anterolateral thigh, and 36 vastus lateralis-only flaps. There were no significant differences in complications between medial (17.4%) and lateral thigh (21.3%) donor sites, although lateral thigh flaps had a mean of 1 additional postoperative visit. Rates of wound dehiscence/healing issues were significantly higher in both gracilis myocutaneous flaps (25.9%) and flaps requiring a skin grafted donor site (31.2%). Postoperative therapeutic anticoagulation was the only significant risk factor for a donor-site complication. Flap complications resulted in increased drain duration and postoperative office visits.Conclusions:Donor-site morbidity is similar in both lateral and medial thigh-based flaps. The inclusion of muscle in the flap from either donor site does not seem to increase complications, but the inclusion of a skin paddle with gracilis muscle, or a skin grafted lateral thigh donor site, results in increased wound healing complications.

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Section: Discussionmentioning

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Donor-site Morbidity of Medial and Lateral Thigh-based Flaps: A Comparative Study

Purnell

Lewis

Mioton³

et al. 2016

Plastic and Reconstructive Surgery - Global Open

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“…Cependant plusieurs inconvénients sont à déplorer : il s'agit d'un lambeau musculocutané, le prélèvement musculaire pouvant entraîner des séquelles douloureuses ou fonctionnelles même s'il est admis que l'absence de muscle gracilis provoque une morbidité faible mais non nulle [21,23,25,26]. L'atrophie du muscle gracilis est inévitable dans les mois suivant l'intervention, impliquant un faible volume du sein reconstruit.…”

Section: Discussionunclassified

“…L'indice de masse corporel moyen (IMC) était de 23,7 (18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)5). Dix-sept patientes (57 %) ont eu de la radiothérapie en préopératoire.…”

Section: Résultatsunclassified

Reconstruction mammaire par profunda artery perforator flap : étude prospective des 30 premiers cas consécutifs

Haddad¹,

Hunsinger²,

Obadia³

et al. 2016

Annales de Chirurgie Plastique Esthétique

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“…In patients who undergo autologous tissue reconstruction, common donor sites include the abdomen (Fig. d), back, thigh, and buttock; and pain or scarring in these sites may also interfere with sexual function . If the donor tissue was from the abdomen, then the abdominal wall is evaluated for evidence of hernia, bulge, and scar‐related discomfort .…”

Section: The Comprehensive Physical Examinationmentioning

confidence: 99%

Physical examination of the female cancer patient with sexual concerns: What oncologists and patients should expect from consultation with a specialist

Lindau

Abramsohn

Baron

et al. 2016

CA A Cancer J Clinicians

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Sexual concerns are prevalent in women with cancer or cancer history and are a factor in patient decision-making about cancer treatment and risk-reduction options. Physical examination of the female cancer patient with sexual concerns, regardless of the type or site of her cancer, is an essential and early component of a comprehensive evaluation and effective treatment plan. Specialized practices are emerging that focus specifically on evaluation and treatment of women with cancer and sexual function problems. As part of a specialized evaluation, oncologists and their patients should expect a thorough physical examination to identify or rule out physical causes of sexual problems or dysfunction. This review provides oncology professionals with a description of the physical examination of the female cancer patient with sexual function concerns. This description aims to inform anticipatory guidance for the patient and to assist in interpreting specialists’ findings and recommendations. In centers or regions where specialized care is not yet available, this review can also be used by oncology practices to educate and support health care providers interested in expanding their practices to treat women with cancer and sexual function concerns.

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Donor-Site Morbidity following Harvest of the Transverse Myocutaneous Gracilis Flap for Breast Reconstruction

Abstract: Therapeutic, IV.

Cited by 47 publications

References 17 publications

Donor-site Morbidity of Medial and Lateral Thigh-based Flaps: A Comparative Study

Donor-site Morbidity of Medial and Lateral Thigh-based Flaps: A Comparative Study

Reconstruction mammaire par profunda artery perforator flap : étude prospective des 30 premiers cas consécutifs

Physical examination of the female cancer patient with sexual concerns: What oncologists and patients should expect from consultation with a specialist

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