Effects of DIEP flap-based breast reconstruction on respiratory function

Sorotos, Michail; Firmani, Guido; Schiavone, Laurenza; Rícci, Alberto; Pompeo, Fabio Santanelli di

doi:10.1016/j.bjps.2023.02.025

Cited by 2 publications

(2 citation statements)

References 39 publications

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“…This needs further study. To avoid respiratory complications following myocutaneous flap transfers in patients with low FEV1.0%, several approaches can be considered: a skin graft to avoid tight wound closure when harvesting LD or PM flaps; abdominal flaps, because in the study of deep inferior epigastric perforator flaps for breast reconstruction, respiratory function was not negatively affected ( 27 ); free flap from fascia lata, anterolateral thigh, or similar, except for the chest wall; and preoperative inspiratory muscle training ( 28 ).…”

Section: Discussionmentioning

confidence: 99%

Pedicled flap transfer after chest wall malignant tumor resection and potential risk of postoperative respiratory problems for patients with low FEV1.0%

Asanuma,

Tsujii,

Hagi

et al. 2024

Front. Surg.

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IntroductionMusculoskeletal transfer for chest wall tissue defects is a crucial method, and pedicled flaps around the chest wall are preferred in terms of location and simplicity of transfer. These require special care because of complications such as partial necrosis, fistula, wound dehiscence, infection, hematoma and restricted function of the arm or shoulder. However, studies of respiratory function are rare. In the present study, we investigated the complications including respiratory problems after wide resection for malignant chest wall tumors with musculoskeletal pedicle transfer.MethodsA total of 13 patients (15 operations) who underwent wide resection of primary, recurrent, or metastatic malignant chest wall tumors and musculoskeletal pedicle transfer for coverage of tissue defects were enrolled in the present study. A retrospective review of all patients was performed using data collected from hospital records and follow-up information. The complications of musculoskeletal transfer after chest wall wide resection, including respiratory problems, are evaluated.ResultsRib or sternal resection was performed in 12 operations, and only soft tissue resection was performed in 3 operations. Latissimus dorsi (LD) pedicle transfer was performed in 13 operations, and pectoralis major (PM) pedicle transfer was performed in 2 operations; basically, wounds were closed primarily. Surgical complications were observed following 5 of the 15 operations (33.3%). Respiratory complications were seen in 7 of the 15 operations (46.7%). Patients with respiratory complications showed significantly lower preoperative FEV1.0% values than those without respiratory complications (p = 0.0196). Skin resection area tended to be higher in the complication group than in the no complication group (p = 0.104).DiscussionPedicled myocutaneous flap transfers such as LD, PM, and rectus abdominus can be used following multiple resections. After harvesting LD or PM, the wound can be closed primarily for an 8–10-cm skin defect in patients with normal respiratory function. However, for patients with low FEV1.0%, after primary closure of LD or PM transfer for wide soft tissue defects, attention should be paid to postoperative respiratory complications.

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Section: Discussionmentioning

confidence: 99%

Pedicled flap transfer after chest wall malignant tumor resection and potential risk of postoperative respiratory problems for patients with low FEV1.0%

Asanuma,

Tsujii,

Hagi

et al. 2024

Front. Surg.

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“…Among the alternatives for autologous breast reconstruction, the deep inferior epigastric artery perforator (DIEP) flap is still considered the gold standard [ 45 , 46 ]. In this procedure, abdominal tissues, which include subcutaneous fat and skin from the lower abdomen, are transferred as a vascularized free flap to reconstruct the breast.…”

Section: Preoperative Applicationsmentioning

confidence: 99%

Three-Dimensional Printing in Breast Reconstruction: Current and Promising Applications

Mayer,

Coloccini,

Viñas

2024

JCM

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Three-dimensional (3D) printing is dramatically improving breast reconstruction by offering customized and precise interventions at various stages of the surgical process. In preoperative planning, 3D imaging techniques, such as computer-aided design, allow the creation of detailed breast models for surgical simulation, optimizing surgical outcomes and reducing complications. During surgery, 3D printing makes it possible to customize implants and precisely shape autologous tissue flaps with customized molds and scaffolds. This not only improves the aesthetic appearance, but also conforms to the patient’s natural anatomy. In addition, 3D printed scaffolds facilitate tissue engineering, potentially favoring the development and integration of autologous adipose tissue, thus avoiding implant-related complications. Postoperatively, 3D imaging allows an accurate assessment of breast volume and symmetry, which is crucial in assessing the success of reconstruction. The technology is also a key educational tool, enhancing surgeon training through realistic anatomical models and surgical simulations. As the field evolves, the integration of 3D printing with emerging technologies such as biodegradable materials and advanced imaging promises to further refine breast reconstruction techniques and outcomes. This study aims to explore the various applications of 3D printing in breast reconstruction, addressing current challenges and future opportunities.

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Effects of DIEP flap-based breast reconstruction on respiratory function

Cited by 2 publications

References 39 publications

Pedicled flap transfer after chest wall malignant tumor resection and potential risk of postoperative respiratory problems for patients with low FEV1.0%

Pedicled flap transfer after chest wall malignant tumor resection and potential risk of postoperative respiratory problems for patients with low FEV1.0%

Three-Dimensional Printing in Breast Reconstruction: Current and Promising Applications

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