Individual difference in pectoralis major muscle thickness and its effect on single-stage breast reconstruction using a tissue expander

Ishii, Naohiro; Ando, Jun; Harao, Michiko; Takemae, Masaru; Kishi, Kazuo

doi:10.1007/s12282-017-0785-9

Cited by 3 publications

(2 citation statements)

References 10 publications

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“…Indeed, the average PMM thickness ranges approximately 5-25 mm depending on sex, age, race, and medical history. [7][8][9] Furthermore, Koo et al 9 reported an average PMM thickness of 21.4 mm in healthy young White men. Thus, the use of intraoperative ICG-FA of PMM for visualizing blood flow should be suitable in most patients.…”

Section: Discussionmentioning

confidence: 99%

A Shaped Pectoralis Major Muscle Flap under Indocyanine Green Fluorescence Angiography for Sternal Wound Infection

Sato,

Nakai,

Suda

et al. 2024

Plastic and Reconstructive Surgery - Global Open

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Summary: The treatment of a sternal wound infection is challenging because it requires radical debridement and reconstruction with a well-vascularized flap. The defects after debridement are three-dimensionally complex, especially if synthetic grafts are involved. Although the pectoralis major muscle (PMM) flap is useful for reconstruction, it is difficult to fill up the complex dead space surrounding the vascular prosthesis when using a conventional PMM flap. Herein, we describe a new technique of splitting and shaping the PMM flap to fit the complex defect. Intraoperative indocyanine green fluorescence angiography was used to assess dynamic blood flow of the PMM supplied by internal mammary artery perforators. This technique allows the PMM flap to be split and shaped to securely fit the dead space, which may improve the healing rate.

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Section: Discussionmentioning

confidence: 99%

A Shaped Pectoralis Major Muscle Flap under Indocyanine Green Fluorescence Angiography for Sternal Wound Infection

Sato,

Nakai,

Suda

et al. 2024

Plastic and Reconstructive Surgery - Global Open

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“…Still, a complete musculofascial closure can be difficult if the pectoralis major muscle is thin, has poor elasticity, or has a short and medialized insertion, which happens quite frequently in thin patients. 5 In such circumstances, the lateral-lower portion of the expander may be exposed. To solve this old problem, our team has designed a simple solution.…”

mentioning

confidence: 99%

Fascio-adipose Intramammary Fold Flap for Full Expander Coverage in Breast Reconstruction

Baccarani,

Marra,

De Maria

et al. 2023

Plastic and Reconstructive Surgery - Global Open

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Construction of multi-component finite element model to predict biomechanical behaviour of breasts during running and quantification of the stiffness impact of internal structure

Chen,

Sun,

Liu

et al. 2024

Biomech Model Mechanobiol

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This study aims to investigate the biomechanical behaviour and the stiffness impact of the breast internal components during running. To achieve this, a novel nonlinear multi-component dynamic finite element method (FEM) has been established, which uses experimental data obtained via 4D scanning technology and a motion capture system. The data are used to construct a geometric model that comprises the rigid body, layers of soft tissues, skin, pectoralis major muscle, fat, ligaments and glandular tissues. The traditional point-to-point method has a relative mean absolute error of less than 7.92% while the latest surface-to-surface method has an average Euclidean distance (d) of 7.05 mm, validating the simulated results. After simulating the motion of the different components of the breasts, the displacement analysis confirms that when the motion reaches the moment of largest displacement, the displacement of the breast components is proportional to their distance from the chest wall. A biomechanical analysis indicates that the stress sustained by the breast components in ascending order is the glandular tissues, pectoralis major muscle, adipose tissues, and ligaments. The ligaments provide the primary support during motion, followed by the pectoralis major muscle. In addition, specific stress points of the breast components are identified. The stiffness impact experiment indicates that compared with ligaments, the change of glandular tissue stiffness had a slightly more obvious effect on the breast surface. The findings serve as a valuable reference for the medical field and sports bra industry to enhance breast protection during motion.

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Individual difference in pectoralis major muscle thickness and its effect on single-stage breast reconstruction using a tissue expander

Abstract: These findings demonstrate the usefulness of preoperative measurement of PM thickness in planning of breast reconstruction using a TE. Dissection should be performed more carefully in patients with average PM thickness less than 2.9 mm.

Cited by 3 publications

References 10 publications

A Shaped Pectoralis Major Muscle Flap under Indocyanine Green Fluorescence Angiography for Sternal Wound Infection

A Shaped Pectoralis Major Muscle Flap under Indocyanine Green Fluorescence Angiography for Sternal Wound Infection

Fascio-adipose Intramammary Fold Flap for Full Expander Coverage in Breast Reconstruction

Construction of multi-component finite element model to predict biomechanical behaviour of breasts during running and quantification of the stiffness impact of internal structure

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