266 results match your criteria Breast Reconstruction Other Free Flaps


An Individualized Patient-centric Approach and Evolution towards Total Autologous Free Flap Breast Reconstruction in an Academic Setting.

Plast Reconstr Surg Glob Open 2020 Apr 7;8(4):e2681. Epub 2020 Apr 7.

Department of Plastic Surgery, University of Texas Southwestern Medical Center, Dallas, Tex.

Advances with newer perforator flaps and complex microsurgical techniques have enabled creative solutions in autologous breast reconstruction. For patients seeking total autologous breast reconstruction without the use of implants, body regions other than the abdomen have emerged to provide a substitute or additional donor tissue. In cases where abdominal perforator flaps are not possible (as with prior abdominoplasty), flaps taken from the lower back or thigh can be used. Read More

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http://dx.doi.org/10.1097/GOX.0000000000002681DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7209872PMC

Secondary "Hybrid Reconstruction" Concept with Silicone Implants After Autologous Breast Reconstruction - Is It Safe and Reasonable?

Med Sci Monit 2020 May 10;26:e921329. Epub 2020 May 10.

Department of Plastic and Hand Surgery, University of Erlangen, Erlangen, Germany.

BACKGROUND The use of autologous tissue for breast reconstructive surgery following mastectomy has become routine and allows for excellent symmetry and aesthetic results. However, in some cases, the amount of tissue available from the utilized flaps is not enough to achieve the desired outcome. The use of autologous fat grafting, as well as other techniques, has been described to deal with such problems. Read More

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http://dx.doi.org/10.12659/MSM.921329DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7238811PMC

[Effects of pedicled rectus abdominis myocutaneous flap combined with free deep inferior epigastric artery perforator flap carrying inguinal lymphatic flap in breast reconstruction and upper limb lymphedema treatment post radical mastectomy].

Zhonghua Shao Shang Za Zhi 2020 Apr;36(4):297-303

Department of Oncology Plastic Surgery, Hunan Province Cancer Hospital, Changsha 410008, China.

To explore the effects of pedicled rectus abdominis myocutaneous (PRAM)flap combined with free deep inferior epigastric artery perforator (DIEAP) flap carrying inguinal lymphatic flap in breast reconstruction and upper limb lymphedema treatment post radical mastectomy. From October 2014 to September 2016, 9 patients with upper limb lymphedema after mastectomy were treated with PRAM flap combined with free DIEAP flap carrying inguinal lymphatic flap for breast reconstruction and upper limb lymphedema treatment in Hunan Province Cancer Hospital. The patients were all females, aged 34-66 (44±7) years. Read More

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http://dx.doi.org/10.3760/cma.j.cn501120-20190117-00011DOI Listing

The use of venous anastomotic flow couplers to monitor buried free DIEP flap reconstructions following nipple-sparing mastectomy.

JPRAS Open 2020 Mar 4;23:50-54. Epub 2019 Nov 4.

Department of Plastic Surgery, Wythenshawe Hospital, Manchester University NHS Foundation Trust, United Kingdom.

Nipple sparing mastectomy with free tissue transfer for breast reconstruction offers excellent aesthetic outcomes but poses a challenge in monitoring the buried flap. Venous anastomotic flow couplers directly monitor buried flaps without the need for monitoring skin paddles. In a two year period we used the Synovis GEM™ flow coupler on 24 DIEP flaps. Read More

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http://dx.doi.org/10.1016/j.jpra.2019.09.002DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7061618PMC

The perforator flap from the contralateral large healthy breast as an alternative for breast reconstruction or combined breast and thoracic reconstruction.

Microsurgery 2020 Feb 18. Epub 2020 Feb 18.

Department of Plastic and Reconstructive Surgery, Shanghai 9th People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, PR China.

Background: It has been demonstrated that contralateral breast tissue can be used for delayed breast reconstruction. The current report presented the clinical outcomes of the perforator flap from the contralateral lower breast as a pedicled flap for immediate or delayed breast reconstruction and as a free flap for delayed breast reconstruction or simultaneous breast and thoracic reconstruction in patients with macromastia.

Methods: From June 2014 to August 2018, a total of 15 female patients with a mastectomy defect on one side and a large healthy breast on the other side were collected in our department. Read More

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http://dx.doi.org/10.1002/micr.30570DOI Listing
February 2020
2.421 Impact Factor

The Effects of Adjunctive Pain Medications on Postoperative Inpatient Opioid Use in Abdominally Based Microsurgical Breast Reconstruction.

Ann Plast Surg 2020 Feb 5. Epub 2020 Feb 5.

From the Division of Plastic Surgery, University of Pennsylvania Health System, Philadelphia, PA.

Background: The purposes of this study were to quantify the amount of opioid medication used postoperatively in the hospital setting after abdominally based microsurgical breast reconstruction, to determine factors that are associated with increased opioid use, and to identify other adjunctive medications that may contribute to decreased opioid use.

Methods: An electronic medical record data pull was performed at the University of Pennsylvania from November 2016 to October 2018. Cases were identified using Current Procedural Terminology code 19364. Read More

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http://dx.doi.org/10.1097/SAP.0000000000002249DOI Listing
February 2020

Make Your Own Deep Inferior Epigastric Artery Perforator Flap: Perforator Delay Improves Deep Inferior Epigastric Artery Perforator Flap Reliability.

Plast Reconstr Surg Glob Open 2019 Nov 27;7(11):e2478. Epub 2019 Nov 27.

Division of Plastic Surgery, Department of Surgery, University of Pennsylvania, Philadelphia, Pa.

Abdominal-based autologous breast reconstruction remains a conflict between blood supply and donor site complication. Optimizing esthetics and minimizing recovery and postoperative pain add further complexity. We present a 2-stage technique of deep inferior epigastric artery perforator flap reconstruction to (1) reliably harvest single-vessel flaps while minimizing fat necrosis, (2) decrease abdominal wall morbidity, and (3) improve breast and donor site esthetics. Read More

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http://dx.doi.org/10.1097/GOX.0000000000002478DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6908364PMC
November 2019

Meta-analysis of venous anastomosis techniques in free flap reconstruction.

J Plast Reconstr Aesthet Surg 2020 Mar 29;73(3):409-420. Epub 2019 Nov 29.

Department of Plastic, Reconstructive and Burns Surgery, Buckinghamshire Healthcare NHS Trust, United Kingdom; Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, United Kingdom. Electronic address:

Background: Coupler devices and hand-sewn anastomosis techniques are both routinely employed for venous anastomosis in microsurgical free flap transfer. However, uncertainty remains about whether those two techniques are different in terms of risk of venous thrombosis. The aim of this review was to evaluate the quality of the evidence and quantify the difference in venous thrombosis rates in both techniques. Read More

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http://dx.doi.org/10.1016/j.bjps.2019.11.033DOI Listing

Applications of rib sparing technique in internal mammary vessels exposure of abdominal free flap breast reconstructions: a 12-year single-center experience of 215 cases.

Gland Surg 2019 Oct;8(5):477-485

Department of Breast Surgery, Breast Cancer Institute, Fudan University Shanghai Cancer Center, Shanghai 200032, China.

Background: Internal mammary vessels (IMVs) are widely used recipient vessels in abdominal free flap breast reconstructions. Rib sparing technique is an alternative method with less damage in IMVs exposure. This study aims to investigate the factors influencing the selection of IMVs, as well as analyze the applicability and related factors of rib sparing technique in abdominal breast reconstruction. Read More

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http://dx.doi.org/10.21037/gs.2019.08.08DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6842765PMC
October 2019

Additional venous anastomosis in free profunda artery perforator flap transfer using the posterior accessory saphenous vein.

J Plast Reconstr Aesthet Surg 2019 Dec 24;72(12):1936-1941. Epub 2019 Sep 24.

Department of Plastic and Reconstructive Surgery, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 1138655, Japan.

Background: The profunda artery perforator (PAP) flap has recently been widely used for head and neck as well as breast reconstruction. Although this flap has various advantages, its vascular pedicle is relatively smaller and shorter than that of other workhorse flaps such as the anterolateral thigh flap. The posterior accessory saphenous vein (pASV) is a branch of the great saphenous vein, which runs in the posteromedial aspect of the thigh and can be included in the PAP flap. Read More

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http://dx.doi.org/10.1016/j.bjps.2019.09.013DOI Listing
December 2019

The reconstructive journey: Description of the breast reconstruction pathway in a high-volume UK-based microsurgical centre.

J Plast Reconstr Aesthet Surg 2019 Dec 18;72(12):1930-1935. Epub 2019 Sep 18.

Queen Victoria Hospital, East Grinstead, United Kingdom.

Introduction: Autologous breast reconstruction, on its own, is a complex microsurgical procedure. However, this operation is usually just one of a series of steps along a patient's reconstructive journey. This includes not only a primary major surgical event but also the consequent recovery, potential complications and secondary surgeries required to optimise the final outcome. Read More

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http://dx.doi.org/10.1016/j.bjps.2019.07.017DOI Listing
December 2019

Gabapentin Decreases Narcotic Usage: Enhanced Recovery after Surgery Pathway in Free Autologous Breast Reconstruction.

Plast Reconstr Surg Glob Open 2019 Aug 8;7(8):e2350. Epub 2019 Aug 8.

Department of Plastic and Reconstructive Surgery, MedStar Georgetown University Hospital, Washington, D.C.

The opioid crisis is public health emergency, in part due to physician prescribing practices. As a result, there is an increased interest in reducing narcotic use in the postsurgical setting.

Methods: From January 1, 2018, to October 31, 2018, we employed a multidisciplinary, multimodal Enhanced Recovery After Surgery (ERAS) pathway abdominally based free tissue transfer involving the rectus. Read More

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http://dx.doi.org/10.1097/GOX.0000000000002350DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6756647PMC
August 2019
1 Read

A Simplified Cost-Utility Analysis of Inpatient Flap Monitoring after Microsurgical Breast Reconstruction and Implications for Hospital Length of Stay.

Plast Reconstr Surg 2019 10;144(4):540e-549e

Philadelphia, Pa.; and Boston, Mass. From the Department of Surgery, Division of Plastic and Reconstructive Surgery, University of Pennsylvania; the Division of Plastic and Reconstructive Surgery, Beth Israel Deaconess Medical Center; and the Department of Surgery, Division of Plastic and Reconstructive Surgery, Northwell Health System.

Background: The number of free flap take-backs and successful salvages following microsurgical breast reconstruction decreases as time from surgery increases. As a result, the cost of extended inpatient monitoring to achieve a successful flap salvage rises rapidly with each postoperative day. This study introduces a simplified cost-utility model of inpatient flap monitoring and identifies when cost-utility exceeds the thresholds established for other medical treatments. Read More

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http://Insights.ovid.com/crossref?an=00006534-201910000-0000
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http://dx.doi.org/10.1097/PRS.0000000000006010DOI Listing
October 2019
7 Reads

An evaluation of access to critical breast oncoplastic patient information within a regional autologous free-flap reconstruction service.

Ecancermedicalscience 2019 18;13:ed92. Epub 2019 Jul 18.

Department of Breast Surgery, Charing Cross Hospital, Fulham Palace Road, London W6 8TF, UK.

The configuration of autologous free-flap breast reconstruction services within regional hubs means that increasing numbers of patients operated upon at these units will be external referrals without their oncological investigations carried out at the tertiary receiving centre. Oncoplastic guidelines exist that clearly state the minimum necessary patient information that should be provided by the referring unit to the reconstruction centre. However, the logistics of such critical information transfer can be challenging, but it is essential that such issues are addressed to ensure safe oncological management of patients undergoing autologous breast reconstruction. Read More

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http://dx.doi.org/10.3332/ecancer.2019.ed92DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6695124PMC
July 2019
2 Reads

Surgical Treatment of Lymphedema.

Plast Reconstr Surg 2019 09;144(3):738-758

Houston, Texas From the Department of Plastic Surgery, University of Texas M. D. Anderson Cancer Center.

Lymphedema affects up to 250 million people worldwide. The understanding of the pathophysiology of the condition, however, is incomplete and a cure remains elusive. A growing body of evidence supports the effectiveness of modern surgical techniques in ameliorating the long-term disability and functional impairment inflicted by lymphedema on the lives of those affected. Read More

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http://dx.doi.org/10.1097/PRS.0000000000005993DOI Listing
September 2019
5 Reads

A method using the cephalic vein for superdrainage in breast reconstruction.

Microsurgery 2019 Sep 22;39(6):502-508. Epub 2019 Jul 22.

Department of Plastic and Reconstructive Surgery, Chiba Cancer Center Hospital, Chiba, Japan.

Background: In breast reconstruction, a superdrainage procedure using the superficial inferior epigastric vein has been described. The purpose of this study was to investigate whether the utility of cephalic vein (CV) was equivalent to that of serratus anterior muscle branch of the thoracodorsal vein (SA) and lateral thoracic vein (LTV) for recipient vein.

Methods: Eighty-eight patients were enrolled in this study. Read More

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http://dx.doi.org/10.1002/micr.30489DOI Listing
September 2019
1 Read

Assessing the Relationship between Anxiety and Revision Surgery following Autologous Breast Reconstruction.

Plast Reconstr Surg 2019 07;144(1):24-33

Durham, N.C. From the Division of Plastic, Maxillofacial, and Oral Surgery, Duke University Medical Center; and the Department of Biostatistics and Bioinformatics, Duke Cancer Institute.

Background: Revision procedures address contour irregularities and aesthetic concerns following autologous breast reconstruction. Mental health diagnoses are known to influence patient satisfaction with reconstruction. The authors aimed to identify oncologic, reconstructive, and demographic factors, including mental health diagnoses, associated with the number of revisions after autologous breast reconstruction. Read More

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http://dx.doi.org/10.1097/PRS.0000000000005696DOI Listing
July 2019
3 Reads

Immediate Bilateral Breast Reconstruction Using Abdominally Based Flaps: An Analysis of the Nationwide Inpatient Sample Database.

J Reconstr Microsurg 2019 Oct 10;35(8):594-601. Epub 2019 May 10.

Division of Plastic and Reconstructive Surgery, University of Utah School of Medicine, Salt Lake City, Utah, United States.

Background:  Bilateral mastectomy rates are increasing in the United States. The abdomen is the most common harvest site for autologous reconstruction. Nationwide data were examined to determine differences in hospital charges, length of stay (LOS), and early postoperative complications following immediate bilateral pedicled transverse rectus abdominis myocutaneous (pTRAM), free TRAM (fTRAM), deep inferior epigastric perforator (DIEP), and superficial inferior epigastric artery (SIEA) perforator flaps and were compared with unilateral reconstruction. Read More

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http://www.thieme-connect.de/DOI/DOI?10.1055/s-0039-1688719
Publisher Site
http://dx.doi.org/10.1055/s-0039-1688719DOI Listing
October 2019
12 Reads

[Clinical effects of free deep inferior epigastric perforator flap carrying lymphatic groin flap for treatment of upper limb lymphedema after radical mastectomy and breast reconstruction].

Zhonghua Shao Shang Za Zhi 2019 Apr;35(4):277-283

Department of Oncology Plastic Surgery, Hunan Cancer Hospital, Changsha 410008, China.

To explore the clinical effects of free deep inferior epigastric perforator flap carrying lymphatic groin flap for treatment of upper limb lymphedema after radical mastectomy and breast reconstruction. From October 2014 to December 2016, 10 female patients, aged 37-60 (48±8) years, who had lymphedema in the upper limb after radical mastectomy, were admitted to Department of Oncology Plastic Surgery of Hunan Cancer Hospital. Three patients suffered recurrent erysipelas infections, and 4 patients suffered consistent neuropathic pain in the upper limb. Read More

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http://dx.doi.org/10.3760/cma.j.issn.1009-2587.2019.04.007DOI Listing
April 2019
10 Reads

Reducing Length of Stay after Microsurgical Breast Reconstruction with a Standardized Postoperative Protocol.

J Reconstr Microsurg 2019 Oct 1;35(8):557-567. Epub 2019 May 1.

Department of Surgery, Division of Plastic Surgery, Hofstra Northwell School of Medicine; Northwell Health System, Manhasset, New York, United States.

Background:  Despite widespread acceptance of enhanced recovery after surgery protocols in other surgical specialties, plastic surgery has been slow to adopt fast-track principles. Recently, however, studies have shown that patients undergoing microsurgical breast reconstruction may benefit from a comprehensive postoperative protocol.

Methods:  All microsurgical breast reconstructions with abdominal free flaps performed by the senior author (A. Read More

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http://dx.doi.org/10.1055/s-0039-1687916DOI Listing
October 2019
6 Reads

Anatomical Considerations to Optimize Sensory Recovery in Breast Neurotization with Allograft.

Plast Reconstr Surg Glob Open 2018 Nov 7;6(11):e1985. Epub 2018 Nov 7.

Plastic and Reconstructive Surgery, University of Ljubljana, Ljubljana, Slovenia, EU.

Background: Breast numbness is a recognized problem following mastectomy and subsequent reconstruction. Contemporary literature acknowledges the positive role of breast neurotization, but it is characterized by a variety of technical approaches and substantial heterogeneity with respect to the degree of recovered sensibility that remains suboptimal in comparison with other sensory nerve reconstructions. This study's purpose was to provide an anatomical basis for observed inconsistencies and therein provide a principle that can be used to develop a technical approach that will optimize sensory recovery. Read More

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http://dx.doi.org/10.1097/GOX.0000000000001985DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6414125PMC
November 2018
9 Reads

Free Tissue Breast Reconstruction.

Semin Plast Surg 2019 Feb 8;33(1):59-66. Epub 2019 Mar 8.

Division of Plastic Surgery, Baylor College of Medicine, Houston, Texas.

Free tissue transfer serves as a modern workhorse for breast reconstruction. Advancements in microsurgical technique have allowed for the development of free flap procedures that produce an aesthetic breast while minimizing donor site morbidity. Here, the authors review the use of different free flap procedures for breast reconstruction with a focus on the preferred and most commonly used flap, the deep inferior epigastric perforator flap. Read More

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http://dx.doi.org/10.1055/s-0039-1677703DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6408251PMC
February 2019
11 Reads

Oncoplastic breast surgery combining partial mastectomy with immediate breast reshaping using multiple local flaps for a patient with slim body.

Breast Cancer 2019 Jul 25;26(4):529-534. Epub 2019 Jan 25.

Department of Digestive Surgery, Breast and Thyroid Surgery, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima, 890-8520, Japan.

Oncoplastic breast surgery (OBS), which combines the concepts of oncologic and plastic surgery, is becoming more common worldwide. We report the results of OBS in a Japanese patient with early breast cancer located on the outer lower quadrant area. We performed OBS combining partial mastectomy with immediate breast reshaping using multiple adipofascial cutaneous flaps and free dermal fat graft because she refused any other OBS. Read More

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http://link.springer.com/10.1007/s12282-019-00948-5
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http://dx.doi.org/10.1007/s12282-019-00948-5DOI Listing
July 2019
6 Reads

[Application of dual-pedicle abdominal flap for unilateral breast reconstruction].

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2019 01;33(1):70-74

Department of Plastic and Reconstructive Surgery, Peking University People's Hospital, Beijing, 100044, P.R.China.

Objective: To explore the effectiveness of dual-pedicle abdominal flap for unilateral breast reconstruction.

Methods: Between March 2014 and March 2018, a clinical data of 19 female patients underwent dual-pedicle abdominal flap reconstruction because of unilateral mastectomy defect was reviewed retrospectively. The median age was 45 years (range, 32-51 years), including 3 immediate breast reconstruction and 16 delayed breast reconstruction, and left side in 7 cases and right side in 12 cases. Read More

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http://www.rrsurg.com/article/10.7507/1002-1892.201807043
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http://dx.doi.org/10.7507/1002-1892.201807043DOI Listing
January 2019
42 Reads

The Impact of Age on Perioperative Complications after Extremity Reconstruction with the Free Gracilis Flap: A Retrospective Cohort Study Involving 153 Patients.

J Reconstr Microsurg 2019 Jul 9;35(6):395-410. Epub 2019 Jan 9.

Department of Hand, Plastic, Reconstructive and Burn Surgery, BG Trauma Center, Eberhard Karls University Tuebingen, Tuebingen, Germany.

Background:  The need for plastic and reconstructive surgery on elderly patients has been on the rise due to an increase in life expectancy in the past decades. Therefore, a study was conducted on young and elderly patients following microsurgical extremity reconstructions with free gracilis muscle flaps with the primary aim to investigate the influence of age and the American Society of Anesthesiologists (ASA) score on the general outcome, as well as surgical and medical complications.

Methods:  A retrospective analysis of 153 patients receiving free gracilis muscle flaps for extremity reconstructions between November 2009 and January 2018 was performed at two partner institutions specialized in microsurgical reconstructions. Read More

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http://dx.doi.org/10.1055/s-0038-1677455DOI Listing
July 2019
25 Reads

Chyle Leak Following Autologous Breast Reconstruction: A Rare Complication of a Deep Inferior Epigastric Artery Perforator Flap.

Ann Plast Surg 2019 02;82(2):193-195

Department of Plastic Surgery, University of Kansas Health System, Kansas City, KS.

Background: While complications of deep inferior epigastric artery perforator flaps are known and well documented, a thorough literature review revealed no other reports of a patient developing a chyle leak following the use of the internal mammary vessels for recipient vessels in autologous breast reconstruction.

Case: A 55-year-old woman underwent free autologous breast reconstruction. She developed a chyle leak during the postoperative period. Read More

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http://dx.doi.org/10.1097/SAP.0000000000001639DOI Listing
February 2019
39 Reads

Lateral Breast and Axillary Reconstruction With Pedicled Parascapular Flap.

Eplasty 2018 26;18:e26. Epub 2018 Sep 26.

Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Louisville, Louisville, Ky.

Immediate flap reconstruction following mastectomy in patients who may require adjuvant radiation therapy can be controversial. However, exposure of vital structure or defects too large for primary closure may necessitate immediate utilization of flaps. In this setting, both functional and cosmetic outcomes must be considered. Read More

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6166232PMC
September 2018
5 Reads

Immediate Unilateral Breast Reconstruction using Abdominally Based Flaps: Analysis of 3,310 Cases.

J Reconstr Microsurg 2019 Jan 29;35(1):74-82. Epub 2018 Jul 29.

Division of Plastic and Reconstructive Surgery, University of Utah, School of Medicine, Salt Lake City, Utah.

Background:  The abdomen is the most common area from which tissue is harvested for autologous breast reconstruction. We sought to examine national data to determine the differences in total hospital charges, length of stay (LOS), and early postoperative complications following pedicled transverse rectus abdominis myocutaneous flap (pTRAM), free TRAM (fTRAM), deep-inferior epigastric perforator (DIEP), and superficial inferior epigastric artery perforator (SIEA) flaps.

Methods:  The 2009-2013 Nationwide Inpatient Sample Database was used to identify patients who underwent a unilateral mastectomy and only one type of abdominally based autologous flap (pTRAM, fTRAM, DIEP, and SIEA) during the same hospital admission. Read More

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http://dx.doi.org/10.1055/s-0038-1667046DOI Listing
January 2019
13 Reads

Medial Arm Flap: An Unexplored Option for Autologous Breast Reconstruction in the Setting of Morbid Obesity.

Ann Plast Surg 2019 02;82(2):190-192

Department of Plastic and Reconstructive Surgery, Hospital General Dr. Ruben Leñero, Mexico City, Mexico.

Currently, deep inferior epigastric perforator flap is undoubtedly the first choice for autologous breast reconstruction for most surgeons; however, there are instances where lower abdominal tissue is unavailable for microvascular transfer. In these cases, most surgeons choose gluteal or lower-extremity territories as donor sites.In the setting of morbid obesity, there is an increased risk of flap and donor site complications, as well as increased blood loss, surgical time, and risk of deep venous thrombosis, not to mention a more challenging surgical technique. Read More

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http://dx.doi.org/10.1097/SAP.0000000000001586DOI Listing
February 2019
5 Reads

Autologous reconstruction following nipple sparing mastectomy: a comprehensive review of the current literature.

Gland Surg 2018 Jun;7(3):316-324

Division of Plastic and Reconstructive Surgery, Mount Sinai Health System, New York, NY, USA.

As surgical methods continue to evolve and patients become more educated consumers of their medical care, both oncologic breast surgeons and reconstructive plastic surgeons should understand the current options for surgical management of breast cancer. This review evaluates the current autologous breast reconstruction options following nipple sparing mastectomy (NSM). A comprehensive review of the current literature discussing autologous reconstruction after NSM was performed. Read More

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http://dx.doi.org/10.21037/gs.2018.05.03DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6006021PMC
June 2018
18 Reads

The Lumbar Artery Perforator Flap in Autologous Breast Reconstruction: Initial Experience with 100 Cases.

Plast Reconstr Surg 2018 07;142(1):1e-8e

Gent, Belgium From the Department of Plastic and Reconstructive Surgery, Gent University Hospital.

Background: The lumbar artery perforator flap is an alternative flap in breast reconstruction for those patients who are not eligible for a deep inferior epigastric artery perforator (DIEAP) flap. Shaping of this flap is easier compared with other flaps because of the quality of the lumbar fat and the gluteal extension.

Methods: Between October of 2010 and June of 2017, a total of 100 lumbar artery perforator free flap breast reconstructions were performed in 72 patients. Read More

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http://dx.doi.org/10.1097/PRS.0000000000004522DOI Listing
July 2018
4 Reads

[Gluteal flap harvest for breast reconstruction].

Ann Chir Plast Esthet 2018 Nov 18;63(5-6):498-504. Epub 2018 Jun 18.

Service de chirurgie plastique, hôpital Salengro, CHRU de Lille, 59037 Lille cedex, France. Electronic address:

The lower gluteal flap is an autologous microsurgical breast reconstruction procedure using the soft tissue of the region of the gluteal sulcus. The perineal extension increases the volume of the sample. The pedicle with one artery and two large veins extends up the ischial notch and can reach 8 to 12cm. Read More

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http://dx.doi.org/10.1016/j.anplas.2018.05.003DOI Listing
November 2018
4 Reads

Oncologic Resection and Reconstruction of the Chest Wall: A 19-Year Experience in a Single Center.

Plast Reconstr Surg 2018 08;142(2):536-547

Helsinki, Finland From the Department of Plastic Surgery, University of Helsinki and Helsinki University Hospital.

Background: The aim of this study was to analyze chest wall reconstruction following oncologic resection performed by a single surgeon over a 19-year period.

Methods: A retrospective review was performed for 135 patients who underwent oncologic chest wall resection from 1997 to 2015.

Results: Average patient age was 57. Read More

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http://dx.doi.org/10.1097/PRS.0000000000004597DOI Listing
August 2018
10 Reads

[Establishment and application of three-dimensional model of deep inferior epigastric artery perforator flap based on computed tomography angiography].

Zhonghua Shao Shang Za Zhi 2018 May;34(5):297-302

Department of Burns and Plastic Surgery, the Second Xiangya Hospital of Central South University, Changsha 410011, China.

To explore the establishment and application of three-dimensional model of deep inferior epigastric artery perforator flap based on computed tomography angiography (CTA). Six patients with breast absence after modified radical mastectomy because of breast cancer, 5 patients with congenital absence of vagina, and 6 patients with Paget's disease of penis and scrotum were hospitalized in our unit from January 2012 to April 2017. The size of wounds after excision of the lesion or that of flaps needed for reconstruction ranged from 17 cm×5 cm to 25 cm×9 cm. Read More

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http://dx.doi.org/10.3760/cma.j.issn.1009-2587.2018.05.010DOI Listing
May 2018
7 Reads

Prospective Evaluation of Obese Patients Undergoing Autologous Abdominal Free Flap Breast Reconstruction.

Plast Reconstr Surg 2018 08;142(2):120e-125e

Houston, Texas From the Department of Plastic Surgery, University of Texas M. D. Anderson Cancer Center.

Background: Obesity has been viewed as a relative contraindication against autologous free flap breast reconstruction because of increased risks of complications, including flap loss.

Methods: The authors conducted a prospective analysis of obese patients undergoing autologous breast reconstruction.

Results: Overall, 72 patients (average age, 48. Read More

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http://dx.doi.org/10.1097/PRS.0000000000004550DOI Listing
August 2018
7 Reads
2.990 Impact Factor

The Functional Impact of Breast Reconstruction: An Overview and Update.

Plast Reconstr Surg Glob Open 2018 Mar 6;6(3):e1640. Epub 2018 Mar 6.

Section of Plastic and Reconstructive Surgery, Memorial Sloan Kettering Cancer Center, New York, N.Y.; and Department of Obstetrics and Gynecology, Hospital of the University of Pennsylvania, Philadelphia, Pa.

As rates of bilateral mastectomy and immediate reconstruction rise, the aesthetic and psychosocial benefits of breast reconstruction are increasingly well understood. However, an understanding of functional outcome and its optimization is still lacking. This endpoint is critical to maximizing postoperative quality of life. Read More

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http://dx.doi.org/10.1097/GOX.0000000000001640DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5908499PMC
March 2018
6 Reads

DIEP Flap Breast Reconstruction Complication Rate in Previously Irradiated Internal Mammary Nodes.

J Reconstr Microsurg 2018 Jul 19;34(6):399-403. Epub 2018 Apr 19.

Department of Plastic and Reconstructive Surgery, Tel-Aviv Sourasky Medical Center, Affiliated with the Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.

Background:  Postmastectomy radiation therapy (PMRT) is a widely accepted treatment for locally advanced breast cancer. Some patients require additional boost radiation to the internal mammary nodes as the part of regional nodal irradiation (RNI). Delayed breast reconstruction with an autologous free flap using the internal mammary vessels for microvascular flap anastomosis is a common practice for these patients. Read More

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http://dx.doi.org/10.1055/s-0038-1625986DOI Listing
July 2018
7 Reads

How Does Autologous Breast Reconstruction Impact Downtime?

J Reconstr Microsurg 2018 Sep 13;34(7):530-536. Epub 2018 Apr 13.

Department of Plastic and Reconstructive Surgery, Guy's and St. Thomas' Hospital NHS Foundation Trust, London, United Kingdom.

Background:  Although autologous breast reconstruction is technically quite demanding, it offers the best outcomes in terms of durable results, patient perceptions, and postoperative pain. Many studies have focused on clinical outcomes and technical aspects of such procedures, but few have addressed the impact of various flaps on patient recovery times. This particular investigation entailed an assessment of commonly used flaps, examining the periods of time required to resume daily activities. Read More

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http://www.thieme-connect.de/DOI/DOI?10.1055/s-0038-1641711
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http://dx.doi.org/10.1055/s-0038-1641711DOI Listing
September 2018
8 Reads

Vascularized Lymph Node Transfer for Lymphedema.

Semin Plast Surg 2018 Feb 9;32(1):28-35. Epub 2018 Apr 9.

Department of Plastic Surgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan.

Advances in our understanding of the lymphatic system and the pathogenesis of lymphedema have resulted in the development of effective surgical treatments. Vascularized lymph node transfer (VLNT) involves the microvascular transplantation of functional lymph nodes into an extremity to restore physiological lymphatic function. It is most commonly performed by transferring combined deep inferior epigastric artery perforator and superficial inguinal lymph node flaps for postmastectomy breast reconstruction. Read More

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http://www.thieme-connect.de/DOI/DOI?10.1055/s-0038-1632401
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http://dx.doi.org/10.1055/s-0038-1632401DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5891655PMC
February 2018
13 Reads

Two-Level Continuous Thoracic Paravertebral Nerve Blocks Providing Opioid-Free Postoperative Analgesia After Latissimus Dorsi Flap Breast Reconstruction: A Case Report.

A A Pract 2018 Sep;11(5):118-120

From the Department of Anesthesiology, University of California San Diego, La Jolla, California.

We present the case of a 55-year-old woman undergoing a delayed latissimus dorsi flap breast reconstruction after a simple mastectomy for breast cancer. Preoperatively, 2 unilateral paravertebral catheters were placed at T3/4 and T7/8 for postoperative analgesia. Postoperatively, ropivacaine 0. Read More

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http://dx.doi.org/10.1213/XAA.0000000000000759DOI Listing
September 2018
3 Reads

Using Mesh to Reinforce the Abdominal Wall in Abdominal Free Flaps for Breast Reconstruction: Is There a Benefit? What are the Risks?

Ann Plast Surg 2018 05;80(5S Suppl 5):S295-S298

From the Department of Plastic and Reconstructive Surgery, Stanford University School of Medicine, Stanford, CA.

Introduction: Abdominal wall integrity may be compromised after abdominal flap harvest for breast reconstruction, leading to bulging or herniation due to weakening of the abdominal wall and dissection through the rectus muscle. Mesh can be used to reinforce the abdominal wall to reduce the risk of hernia formation postoperatively, especially in patients who may be at high risk. In this study, we describe this institution's experience with the use of mesh in the abdominal wall and critically evaluate its impact on patient outcomes and complications. Read More

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http://Insights.ovid.com/crossref?an=00000637-900000000-9743
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http://dx.doi.org/10.1097/SAP.0000000000001468DOI Listing
May 2018
30 Reads

Vulvar field resection based on ontogenetic cancer field theory for surgical treatment of vulvar carcinoma: a single-centre, single-group, prospective trial.

Lancet Oncol 2018 04 9;19(4):537-548. Epub 2018 Mar 9.

Department of Gynecology, Women's and Children's Center, University of Leipzig, Leipzig, Germany.

Background: The incidence of vulvar cancer is increasing, but surgical treatment-the current standard of care-often leads to unsatisfactory outcomes, especially in patients with node-positive disease. Preliminary results at our centre showed that locoregional spread of vulvar carcinoma occurs within tissue domains defined by stepwise embryonic and fetal development (ontogenetic cancer fields and associated lymph node regions). We propose that clinical translation of these insights into practice could improve outcomes of surgical treatment of vulvar cancer. Read More

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http://dx.doi.org/10.1016/S1470-2045(18)30109-8DOI Listing
April 2018
32 Reads

Postoperative outcomes of breast reconstruction after mastectomy: A retrospective study.

Medicine (Baltimore) 2018 Feb;97(5):e9766

Department of Breast Surgery, The Affiliated Tumor Hospital of Guangxi Medical University, Nanning, China.

Breast reconstruction after mastectomy plays an active role in improving the quality-of-life (QoL) and alleviating the psychological trauma of breast cancer patients, and has become an indispensable part of the comprehensive treatment in breast cancer. However, compared with mastectomy alone, breast reconstruction also increase operative complications. The surgical, oncological outcomes, and cosmetic effect of breast reconstruction remains to be evaluated. Read More

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http://dx.doi.org/10.1097/MD.0000000000009766DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5805437PMC
February 2018
9 Reads

Safety of Microsurgery Under Loupes Versus Microscope: A Head-to-Head Comparison of 2 Surgeons With Similar Experiences.

Ann Plast Surg 2018 06;80(6S Suppl 6):S340-S342

From the Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Florida, Gainesville, FL; and Beth Israel Deaconess Medical Center, Boston, MA.

Background: Microsurgery is performed using either the operating microscope or loupe magnification. Use of the operating microscope is considered the "criterion standard"; however, loupes are emerging as a safe and reliable technique to perform microsurgery. The purpose of this study was to analyze the safety of microsurgery under loupe magnification compared with the microscope. Read More

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http://dx.doi.org/10.1097/SAP.0000000000001324DOI Listing
June 2018
14 Reads

Topical nitroglycerin for the treatment of intraoperative microsurgical vasospasm.

Microsurgery 2018 Jul 17;38(5):524-529. Epub 2018 Jan 17.

Division of Plastic and Reconstructive Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA.

Background: Papaverine remains a popular agent to treat intraoperative microsurgical vasospasm. However, the recent shortage has forced surgeons to trial antispasmodic agents unproven in microsurgery, but commonly used in other areas. During this shortage we have trialed topical nitroglycerin to break intraoperative vasospasm. Read More

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http://dx.doi.org/10.1002/micr.30294DOI Listing
July 2018
48 Reads

Concordance between preoperative computed tomography angiographic mapping and intraoperative perforator selection for deep inferior epigastric artery perforator flap breast reconstructions.

Gland Surg 2017 Dec;6(6):620-629

Department of Plastic Surgery, Gelre Hospital, Apeldoorn, the Netherlands.

Background: Preoperative imaging for perforator identification prior to a deep inferior epigastric artery perforator (DIEP) flap elevation for breast reconstruction has many advantages. Currently, computed tomography (CT) angiography provides good visualization of the perforators and their course, and is thus the imaging technique of choice. The primary aim of this study was to determine the concordance between the perforators identified preoperatively and the perforators ultimately selected intraoperatively, with a standardized protocol, in a single institution. Read More

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http://dx.doi.org/10.21037/gs.2017.09.13DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5750307PMC
December 2017
15 Reads

Flap monitoring with continuous oxygen partial tension measurement in breast reconstructive surgery: A preliminary report.

Microsurgery 2018 May 13;38(4):402-406. Epub 2017 Nov 13.

Department of Plastic and Reconstructive Surgery, University of Sassari, Sassari 07100, Italy.

Background: The best method for the postoperative monitoring of flaps in reconstructive surgery is still a matter of debate. The aim of this study is to evaluate the usefulness of an oxygen partial tension monitoring system for the postoperative follow-up of a series of breast flaps, in addition to the traditional periodical clinical evaluations.

Patients And Methods: Twenty-one consecutive female patients (mean age: 61 years) who underwent free- or pedicled-flap reconstruction of the breast were included in the study. Read More

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http://dx.doi.org/10.1002/micr.30256DOI Listing
May 2018
16 Reads

Radiation Therapy Versus No Radiation Therapy to the Neo-breast Following Skin-Sparing Mastectomy and Immediate Autologous Free Flap Reconstruction for Breast Cancer: Patient-Reported and Surgical Outcomes at 1 Year-A Mastectomy Reconstruction Outcomes Consortium (MROC) Substudy.

Int J Radiat Oncol Biol Phys 2017 09 8;99(1):165-172. Epub 2017 May 8.

Department of Radiation Oncology, CancerCare Manitoba, Winnipeg, Manitoba, Canada.

Purpose: To determine whether adjuvant radiation therapy (RT) is associated with adverse patient-reported outcomes and surgical complications 1 year after skin-sparing mastectomy and immediate autologous free flap reconstruction for breast cancer.

Methods And Materials: We compared 24 domains of patient-reported outcome measures 1 year after autologous reconstruction between patients who received adjuvant RT and those who did not. A total of 125 patients who underwent surgery between 2012 and 2015 at our institution were included from the Mastectomy Reconstruction Outcomes Consortium study database. Read More

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http://dx.doi.org/10.1016/j.ijrobp.2017.05.001DOI Listing
September 2017
24 Reads

101 Consecutive Profunda Artery Perforator Flaps in Breast Reconstruction: Lessons Learned with Our Early Experience.

Plast Reconstr Surg 2017 Aug;140(2):229-239

Dallas, Texas; and Philadelphia, Pa. From the Department of Plastic Surgery, University of Texas Southwestern Medical Center; and the Department of Surgery, Division of Plastic Surgery, Temple University.

Background: Free and local flaps based on the profunda artery perforators were first used for reconstruction of pressure sores, burn contractures, and extremity wounds. Recently, a revised profunda artery perforator flap was introduced for breast reconstruction. However, despite increasing reports of the use of the flap, it remains a rarely used option. Read More

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http://dx.doi.org/10.1097/PRS.0000000000003553DOI Listing
August 2017
13 Reads