Trends in Autologous Breast Reconstruction

Carlson, Grant W.

doi:10.1055/s-2004-829042

Cited by 30 publications

(14 citation statements)

References 45 publications

(43 reference statements)

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“…Carlson et al, using autologous flap for the breast mound, reported a 27% complication rate for the SSM type IV on 44 patients, 1 confirmed by further observations in an enlarged population (26.5%) 23 ; Hammond et al, using skin expander after Wise-pattern mastectomy in 19 cases, reported 2 complications with 1 prosthesis extrusion (8,3%) 8 ; Hudson and Skoll reported a 15.7% rate of implant extrusion allocating prosthesis subcutaneously on 19 patients 24 ; Nava et al observed a high severe complications rate requiring implant removal (13%) and a 20% rate of skin problems on 28 patients. 25 In our experience, 24 patients who underwent SSM type V showed an overall complications rate of 20.8% (16.7% minor complications, including epidermolysis and partial thickness skin necrosis that required conservative dressings, and 4.1% major complications including full thickness skin necrosis that required further skin graft), which was lower than our SSM type IV group (25.6% of 51 patients).…”

Section: Discussionmentioning

confidence: 83%

The “Type V” Skin-Sparing Mastectomy for Upper QuadrantSkin Resections

Santanelli

Paolini²,

Campanale³

et al. 2010

Annals of Plastic Surgery

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Skin-sparing mastectomies (SSMs) are classified according to the type of incision and breast size. In large breasts, if cancer is superficially located in the upper quadrants, SSM type IV is not indicated, because tumor resection interferes with skin flap pattern. For these patients, a modified Wise-pattern SSM has been developed to achieve immediate breast reconstruction. Twenty-four patients, 14 with tumor in the superior-lateral, 7 in the superior-medial, and 3 in the inferior-lateral quadrant, were operated on with modified SSM incisions. To replace the skin area removed with mastectomy from the upper quadrants, a similar size area from the lower pole was used. No local or distant recurrences occurred, with a mean follow-up of 27 months. Natural breast shape was achieved in all cases. Our procedure allows for a skin-sparing mastectomy (SSM type V) with immediate reconstruction, achieving a natural breast shape also in this group of patients previously excluded.

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Section: Discussionmentioning

confidence: 83%

The “Type V” Skin-Sparing Mastectomy for Upper QuadrantSkin Resections

Santanelli

Paolini²,

Campanale³

et al. 2010

Annals of Plastic Surgery

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“…18 CCDs have been reported in the literature in small studies to be at around 10%Y20%. In our retrospective study, we confirm this rate of CCD at 11.2%.…”

Section: Discussionmentioning

confidence: 99%

The Matrix Rib Plating System

Ahdoot

Echo²,

Otake

et al. 2013

Annals of Plastic Surgery

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The majority of patients (9 of 11) with compromised aesthetic outcomes had a BMI less than 30 kg/m, suggesting a paucity of overlying soft tissue contributed to visibility of these bony defects. Rib plating prevented chest contour deformity, reduced postoperative pain, and added limited additional morbidity. We believe that rib plating is a safe, useful adjunct to microvascular breast reconstruction using IMVs, as it may improve aesthetic outcomes and reduce postoperative pain.

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“…Among the reconstructions, patients with multiple risk factors had three times the incidence of flap-related complications versus patients with one or no risk factors (13). A careful preoperative history and physical examination is essential to evaluate patients for possible TRAM flap reconstruction.…”

Section: Discussionmentioning

confidence: 99%

Three-layer primary closure of the bipedicled TRAM flap donor site for unilateralbreast reconstruction: a 15-year experience with 124 consecutive patients

Karagöz

Şahi̇n

Sever³

et al. 2017

Turk J Med Sci

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Between 2000 and 2015, 124 patients underwent breast reconstruction with a bipedicled TRAM flap and the three-layer primary closure technique. The patient's risk Background/aim: The pedicled transverse rectus abdominis myocutaneous (TRAM) flap remains widely used as a breast reconstruction technique. The bipedicled TRAM flap is not as preferable as it was formerly, mainly because of its donor site complications. However, in a number of situations, a bipedicled TRAM flap may be the only alternative. Therefore, a three-layer primary closure technique used with bipedicled TRAM flap breast reconstructions that can avoid donor site complications without using a mesh is presented. Materials and methods:A retrospective study was performed that included patients who underwent bipedicled TRAM flap breast reconstruction with the three-layer primary closure technique. Between 2000 and 2015, 124 breast reconstruction patients were reviewed for donor site morbidity.Results: During the 15-year study period, 106 patients had conventional bipedicled TRAM flaps and 18 had bipedicled TRAM flaps with a surgical delay procedure. For all groups, none of the patients developed abdominal wall hernia, but three patients had bulging. Partial flap loss was the most common flap complication, present in 6 flaps (4.8%). Conclusion:The suturing technique studied provided abdominal wall closure without the use of a mesh even when utilizing a bilateral pedicle with very low complication rates.

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Trends in Autologous Breast Reconstruction

Cited by 30 publications

References 45 publications

The “Type V” Skin-Sparing Mastectomy for Upper QuadrantSkin Resections

The “Type V” Skin-Sparing Mastectomy for Upper QuadrantSkin Resections

The Matrix Rib Plating System

Three-layer primary closure of the bipedicled TRAM flap donor site for unilateralbreast reconstruction: a 15-year experience with 124 consecutive patients

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