1,247 results match your criteria Breast Reconstruction Perforator Flap


Quality of life, patient satisfaction and cosmetic outcome after delayed breast reconstruction using DIEP flap: a 10 years' follow-up survey.

J Plast Surg Hand Surg 2019 Jan 18:1-6. Epub 2019 Jan 18.

a Department of Plastic and Reconstructive Surgery , Oslo University Hospital , Oslo , Norway.

Autologous breast reconstruction (BR) aims to restore body image and improve health-related quality of life in women undergoing mastectomy due to breast cancer. We wanted to explore patient-reported cosmetic results and satisfaction 10 or more years post BR surgery, using deep inferior epigastric perforator flap (DIEP). This is a follow-up study based on the same patient population of 34 patients undergoing delayed DIEP-flap procedure during 2001-2004 at Oslo University Hospital investigated by our group and published in 2008; Four patients died during the 10 years' follow-up time and four patients with total or partial flap failure were excluded. Read More

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http://dx.doi.org/10.1080/2000656X.2018.1562459DOI Listing
January 2019

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

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2019 Jan;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
2 Reads

Autologous Breast Reconstruction With a Delay Procedure of the Deep Inferior Epigastric Artery Perforator Flap Because of Venous Congestion of the Flap on Pedicle: A Case Series.

Ann Plast Surg 2019 Jan 9. Epub 2019 Jan 9.

Department of Plastic, Reconstructive & Hand Surgery, Maastricht University Medical Centre, Maastricht, the Netherlands.

The deep inferior epigastric artery perforator (DIEP) flap is one of the most used free flaps for the reconstruction of the breast after a mastectomy. Despite careful selection of the patients and preoperative imaging, difficulties in vascularization of the flap can occur in some cases. Although multiple vascular connections (bipedicled, turbocharged, or stacked) can be made in selected cases, there can still be venous congestion before the flap is transferred. Read More

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http://dx.doi.org/10.1097/SAP.0000000000001752DOI Listing
January 2019

The "Dual-Plane" DIEP Flap: Measuring the Effects of Superficial Arterial and Venous Flow Augmentation on Clinical Outcomes.

J Reconstr Microsurg 2019 Jan 7. Epub 2019 Jan 7.

Division of Plastic and Reconstructive Surgery, University of California San Francisco, San Francisco, California.

Background:  Deep inferior epigastric perforator (DIEP) flaps are routinely elevated on a single dominant perforator from the deep epigastric vascular system. However, the single perforator may not always perfuse an entire flap adequately, particularly suprascarpal tissue. We often perform "dual-plane" single perforator DIEP flaps by rerouting the superficial (SIEA/V) system directly into a branch of the deep (DIEA/V) vascular system pedicle, thus allowing both systems to contribute and enhance flap perfusion. Read More

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http://dx.doi.org/10.1055/s-0038-1677013DOI Listing
January 2019

[Postoperative course after immediate breast reconstruction: Comparison between five surgical techniques].

Ann Chir Plast Esthet 2019 Jan 2. Epub 2019 Jan 2.

Service de chirurgie plastique, hôpital civil Strasbourg, 1, place de l'Hôpital, 67091 Strasbourg, France.

Introduction: This study analyzes postoperative course of different immediate breast reconstruction techniques: deep inferior epigastric perforator flap (DIEP), gracilis, latissimus dorsi flap, expander implants and definitive implants.

Methods: All women operated on IBR between 2012 and 2017 in the CHU Strasbourg were included in this retrospective study. The main data collected were healing time, complications, surgical revisions and failure rates. Read More

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http://dx.doi.org/10.1016/j.anplas.2018.12.001DOI Listing
January 2019
1 Read

[Colgajo DIEP como primera opción de reconstrucción mamaria en pacientes mexicanas con cicatrices abdominales previas].

Cir Cir 2019 ;87(1):53-58

Departamento de Cirugía Plástica y Reconstructiva, Hospital de Traumatología y Ortopedia no. 21, Instituto Mexicano del Seguro Social (IMSS), Monterrey, Nuevo León, México.

Introduction: For many years the abdominal region has been a reliable donor of abundant well-perfused tissue. The subdermal plexus constitutes an intricate network of microvessels that comprise the entire abdominal skin and allow for innumerable and redundant connections.

Method: Using a retrospective cohort study, we considered the first 100 deep inferior epigastric perforator (DIEP) flaps performed for breast reconstruction in the High Specialty Medical Department #21 of the Mexican Institute of Social Security in Monterrey, Nuevo Leon, Mexico, from January 2010 until December 2015. Read More

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http://dx.doi.org/10.24875/CIRU.18000422DOI Listing
January 2019

A cost-effectiveness analysis of DIEP vs free MS-TRAM flap for microsurgical breast reconstruction.

J Surg Oncol 2018 Dec 18. Epub 2018 Dec 18.

Division of Plastic and Reconstructive Surgery, University Health Network, Toronto, Ontario, Canada.

Background And Objectives: The deep inferior epigastric perforator (DIEP) flap may be associated with less long-term donor-site morbidity compared with free muscle-sparing transverse rectus abdominis myocutaneous flap (MS-TRAM) flap. However, DIEP flaps may have longer operative time and higher rates of acute postoperative complications. We performed a cost-effectiveness analysis (CEA) that compared the long-term costs and patient-reported outcomes between the two flaps. Read More

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http://dx.doi.org/10.1002/jso.25325DOI Listing
December 2018
1 Read

Comparison of Polypropylene and Bioabsorbable Mesh for Abdominal Wall Reinforcement following Microsurgical Breast Reconstruction.

J Reconstr Microsurg 2018 Dec 17. Epub 2018 Dec 17.

Department of Plastic Surgery and Reconstructive Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio.

Background:  Abdominal wall morbidity following microvascular breast reconstruction continues to be an area of interest due to both functional and aesthetic concerns. Donor-site closure technique has been shown to affect bulge and hernia rates and ranges from primary closure to various uses of mesh. Few studies to date have compared types of mesh. Read More

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http://dx.doi.org/10.1055/s-0038-1676470DOI Listing
December 2018
1 Read

The Medial Pillar Island Flap for Oncoplastic Breast Reconstruction of Upper Pole Defects.

Ann Plast Surg 2018 Dec 13. Epub 2018 Dec 13.

Surgical Oncology, Department of Surgery, University of Massachusetts Medical School, Worcester, MA.

Background: Breast deformity is common following lumpectomy. Use of ptotic lower pole tissue for restoration of volume in the upper pole is quite appealing since it allows for a concomitant lift. This study presents the medial pillar island flap technique of oncoplastic breast reconstruction of upper pole defects. Read More

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http://dx.doi.org/10.1097/SAP.0000000000001673DOI Listing
December 2018
7 Reads

New Approach to Oncoplastic Breast Conservation: Combining Autologous Volume Replacement and the Wise-pattern Mammaplasty.

Plast Reconstr Surg Glob Open 2018 Oct 16;6(10):e1987. Epub 2018 Oct 16.

Georgia Breast Surgery, Lawrenceville, Ga.

Background: Oncoplastic breast-conserving surgery describes a set of techniques that allow for generous oncological resection with immediate tumor-specific reconstruction. These techniques are classically divided into either volume displacement (local breast flaps and or reduction mammaplasty/mastopexy strategies) versus volume replacement strategies (transfer of autologous nonbreast tissue from a local or distant site and, less commonly, implant placement). There have been few descriptions of merging these 2 classical approaches to facilitate breast-conserving surgery. Read More

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http://dx.doi.org/10.1097/GOX.0000000000001987DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6250486PMC
October 2018
1 Read

In-Vivo Quantitative Mapping of the Perforasomes of Deep Inferior Epigastric Artery Perforators.

Plast Reconstr Surg Glob Open 2018 Oct 4;6(10):e1960. Epub 2018 Oct 4.

Department of Plastic, Reconstructive and Hand Surgery, Peninsula Health, Frankston, Victoria, Australia.

Background: There is limited understanding of anatomy of perforator angiosomes, or "perforasomes," of the deep inferior epigastric artery (DIEA). A perforasome is defined as the territory perfused by a single perforator vessel of a named artery, such as the DIEA. Given the clinical significance of this anatomical concept in microsurgical breast reconstruction, this study is a quantitative investigation of DIEA perforasome characteristics and patterns associated with perforasome size, perforator caliber, location and branching, using computed tomographic (CT) angiography. Read More

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http://Insights.ovid.com/crossref?an=01720096-201810000-0001
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http://dx.doi.org/10.1097/GOX.0000000000001960DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6250480PMC
October 2018
9 Reads

The effect of CT angiography and venous couplers on surgery duration in microvascular breast reconstruction: a single operator's experience.

Gland Surg 2018 Oct;7(5):440-448

Plastic & Reconstructive Surgery Department, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.

Background: The use of CT angiography (CTA) or venous couplers (VCs) has led to shorter operative times in free flap breast reconstruction (FFBR). However, there are no reports on the effect of these two interventions relative to each other or combined.

Methods: Abdominal based FFBRs performed by a single surgeon before introduction of either intervention were compared to those with VC only, and those after the addition of CTA to VCs (CT-VC). Read More

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http://dx.doi.org/10.21037/gs.2018.07.11DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6234237PMC
October 2018

Assessing Age as a Risk Factor for Complications in Autologous Breast Reconstruction.

Plast Reconstr Surg 2018 Dec;142(6):840e-846e

New Orleans, La. From the Division of Plastic and Reconstructive Surgery, Louisiana State University Health Sciences Center.

Background: Breast cancer is primarily a diagnosis of older women. Many patients seeking breast reconstruction are elderly women (aged 65 years or older). However, many surgeons anecdotally believe that surgery in elderly patients is inherently dangerous, or at least prone to more complications. Read More

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http://dx.doi.org/10.1097/PRS.0000000000004990DOI Listing
December 2018
6 Reads

Discussion: The Stacked Hemiabdominal Extended Perforator Flap for Autologous Breast Reconstruction.

Plast Reconstr Surg 2018 Dec;142(6):1435-1436

Dallas, Texas From the Department of Plastic Surgery, University of Texas Southwestern.

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http://dx.doi.org/10.1097/PRS.0000000000005061DOI Listing
December 2018

Utilizing the Retrograde Descending Internal Mammary Vein in DIEP Flap Anastomosis.

Eplasty 2018 29;18:ic23. Epub 2018 Oct 29.

Division of Plastic Surgery, Department of Surgery, Morsani College of Medicine, University of South Florida, Tampa.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6232948PMC
October 2018
1 Read

The Deep Circumflex Iliac Artery Perforator Flap for Breast Reconstruction: Un lambeau perforateur de l'artère iliaque circonflexe profonde pour la reconstruction mammaire.

Plast Surg (Oakv) 2018 Nov 1;26(4):229-237. Epub 2018 Nov 1.

Health Sciences Centre, University of Manitoba, Winnipeg, Manitoba, Canada.

Autologous breast reconstruction using abdominal-based perforator flaps produces excellent aesthetic results with minimal donor site morbidity. The superficial inferior epigastric artery and deep inferior epigastric perforator (DIEP) flaps reliably perfuse a hemi-abdomen, up to the anterior axillary line. Beyond this line laterally, the flank or "love handle" tissue is primarily perfused by the deep circumflex iliac artery (DCIA) or secondarily by the superficial circumflex iliac artery. Read More

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http://dx.doi.org/10.1177/2292550318800329DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6236510PMC
November 2018
3 Reads

Function and Strength after Free Abdominally Based Breast Reconstruction: A 10-Year Follow-Up.

Plast Reconstr Surg 2019 Jan;143(1):22e-31e

New York, N.Y.; Houston, Texas; and Philadelphia, Pa. From the Plastic and Reconstructive Surgery Service, Memorial Sloan Kettering Cancer Center; the Department of Plastic Surgery, M. D. Anderson Cancer Center; and the Division of Plastic Surgery, Perelman School of Medicine at the University of Pennsylvania.

Background: The long-term impact of abdominally based free flap breast reconstruction is incompletely understood. The aim of this study is to provide long-term, subjective and objective health data on abdominally based free flap breast reconstruction patients, with specific attention to the effects of laterality, flap type, and obesity.

Methods: Patients were enrolled in this prospective study between 2005 and 2010 and completed preoperative, early (<1 year), and long-term (5 to 10 years) evaluations. Read More

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http://dx.doi.org/10.1097/PRS.0000000000005096DOI Listing
January 2019

Nipple-sparing Mastectomy and Immediate Breast Reconstruction After Recurrence From Previous Breast Conservation Therapy.

Ann Plast Surg 2019 Jan;82(1S Suppl 1):S95-S102

Purpose: Breast conservation therapy (BCT) is widely accepted for breast cancer treatment. Nipple-sparing mastectomy has been newly developed to preserve the nipple-areolar complex and enhance aesthetic results. The purpose of this study was to evaluate the oncological safety and results of nipple-sparing mastectomy (NSM) after previous BCT. Read More

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http://dx.doi.org/10.1097/SAP.0000000000001696DOI Listing
January 2019

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

Ann Plast Surg 2019 Feb;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
5 Reads

Distribution of internal thoracic artery perforators: A clincal anatomy study.

Clin Anat 2018 Nov 13. Epub 2018 Nov 13.

Department of Plastic and Reconstructive Surgery, Bundang CHA Medical Center, School of Medicine, CHA University, Seongnam, South Korea.

There are various modifications of the transverse rectus abdominis musculocutaneous flap and deep inferior epigastric perforator flap to reduce the morbidity of the donor site or to augment the vascularity of the flap. For microanastomosis of multiple pedicles, multiple recipient vessels or an intervening vein graft should be provided. In addition, alternative perforator-based flaps used in breast reconstruction have small caliber pedicles. Read More

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http://doi.wiley.com/10.1002/ca.23312
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http://dx.doi.org/10.1002/ca.23312DOI Listing
November 2018
8 Reads

Reply: The Lateral Thigh Perforator Flap for Autologous Breast Reconstruction: A Prospective Analysis of 138 Flaps.

Plast Reconstr Surg 2019 Jan;143(1):249e-250e

P. Debeyelaan 25, 6229 HX Maastricht, The Netherlands,

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http://dx.doi.org/10.1097/PRS.0000000000005155DOI Listing
January 2019

Effect of breast reconstruction modality on the development of postmastectomy shoulder morbidity.

J Plast Reconstr Aesthet Surg 2018 Dec 6;71(12):1761-1767. Epub 2018 Aug 6.

Department of Plastic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Irwon-ro 81, Gangnam-gu, Seoul, Korea. Electronic address:

Background: The aim of this study was to evaluate the impact of breast reconstruction modality on the incidence of shoulder morbidity.

Methods: Breast cancer patients who underwent immediate reconstructions using three modalities, namely, tissue expander-implant, latissimus dorsi (LD) pedicled flap, and deep inferior epigastric artery perforator (DIEP) flap, from 2008 to 2013 were examined. The cumulative incidence of shoulder morbidity was compared among the reconstruction modalities, and risk factor analysis was performed using multivariable analysis. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S17486815183027
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http://dx.doi.org/10.1016/j.bjps.2018.07.033DOI Listing
December 2018
6 Reads

Intraoperative Indocyanine Green Angiography for Fat Necrosis Reduction in the Deep Inferior Epigastric Perforator (DIEP) Flap.

Aesthet Surg J 2018 Oct 25. Epub 2018 Oct 25.

Hospital Germans Trias i Pujol, Barcelona, Spain.

Background: Fat necrosis is a frequent complication (up to 62.5%) of microsurgical breast reconstruction using the deep inferior epigastric perforator (DIEP) flap. This could have important clinical and psychological repercussions, deteriorating the results and increasing reconstruction costs. Read More

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http://dx.doi.org/10.1093/asj/sjy256DOI Listing
October 2018

Axillary Reconstruction with a Posterior Circumflex Humeral Artery Perforator Flap as a Salvage Surgery for Axillary Invasion of Advanced Breast Cancer.

Plast Reconstr Surg Glob Open 2018 Sep 14;6(9):e1920. Epub 2018 Sep 14.

Department of Breast and Endocrine Surgery, Osaka Medical College, Osaka, Japan.

A case of advanced breast carcinoma with large skin invasion that extended from the breast to the axilla and which was reconstructed with a meshed split skin graft for the chest defect and a posterior circumflex humeral artery perforator flap for the axillary area was described. When skin invasion of the breast cancer extends to the axillary area, reconstruction methods of the defect are probably complicated. The purpose of reconstruction is not only to close defects, but also to protect important tissues, such as axillary vessels and the brachial plexus. Read More

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http://dx.doi.org/10.1097/GOX.0000000000001920DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6191226PMC
September 2018
9 Reads

The Outpatient DIEP: Safety and Viability following a Modified Recovery Protocol.

Plast Reconstr Surg Glob Open 2018 Sep 14;6(9):e1898. Epub 2018 Sep 14.

Houston Plastic Craniofacial & Sinus Surgery, Houston, Tex.

Background: Breast reconstruction with autologous tissue is considered the current state-of-the-art choice following mastectomies, and the deep inferior epigastric perforator (DIEP) flap is often among the favored techniques. Commonly referred to patients as a combination between a tummy tuck and a breast augmentation, it significantly differs by the required expertise and long hospital stays. We present a series attesting to the feasibility and effectiveness of performing this type of reconstruction in an outpatient setting following our recovery protocol. Read More

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http://dx.doi.org/10.1097/GOX.0000000000001898DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6191230PMC
September 2018

Salvaging Breast Reconstruction: Profunda Artery Perforator Flaps Using Thoracodorsal Vessels.

Plast Reconstr Surg Glob Open 2018 Sep 5;6(9):e1837. Epub 2018 Sep 5.

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

Background: Over the years, the choice of recipient vessels for free flap autologous breast reconstruction has shifted from the thoracodorsal to the internal mammary vessels due to ease of flap inset and predictability of anatomy. However, thoracodorsal vessels are still great recipient vessels, and can be useful, especially in the previously failed or staged autologous breast reconstruction. In this study, we present our experience using thoracodorsal or serratus vessels for profunda artery perforator flaps. Read More

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http://Insights.ovid.com/crossref?an=01720096-201809000-0000
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http://dx.doi.org/10.1097/GOX.0000000000001837DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6191235PMC
September 2018
6 Reads

The superficial and deep inferior epigastric artery composite perforator flap for breast reconstruction: A case report.

Microsurgery 2018 Oct;38(7):799-803

Division of Plastic Surgery, University of Texas Southwestern Medical Center at Dallas, Dallas, Texas.

The superficial inferior epigastric artery (SIEA) flap and the deep inferior epigastric perforator (DIEP) flap have been increasingly adopted for breast reconstruction; however, each have its own set of advantages and disadvantages. In the select subset of patients that cannot tolerate minimal abdominal fasciotomy that occurs with DIEP harvest and do not have adequate pedicle length that often occurs after SIEA harvest, we suggest another option for abdominally-based free flap breast reconstruction. Here, we describe the formation of a composite perforator based on the pedicle of the retro-rectus deep inferior epigastric vessels and the superficial inferior epigastric vessels, known as a superficial and deep inferior epigastric artery (SADIE) flap, which allows for a more compatible anastomotic size match than the SIEA and elongation of the vascular pedicle with minimal dissection of the anterior rectus fascia. Read More

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http://dx.doi.org/10.1002/micr.30362DOI Listing
October 2018

The influence of reconstruction choice and inclusion of radiation therapy on functional shoulder biomechanics in women undergoing mastectomy for breast cancer.

Breast Cancer Res Treat 2018 Oct 16. Epub 2018 Oct 16.

School of Kinesiology, University of Michigan, 401 Washtenaw Ave., CCRB 3730, Ann Arbor, MI, 48109, USA.

Purpose: The functional implications of reconstructing the breast mound with a latissimus dorsi (LD) flap or placing an implant under the pectoralis major (PM) muscle is complicated by potential comorbidities from disinserting these muscles and adjuvant radiotherapy. We utilized novel robot-assisted measures of shoulder stiffness and strength to dissociate how breast reconstruction choice and inclusion of radiation therapy impact shoulder morbidity in post-mastectomy reconstruction patients.

Methods: Shoulder strength and stiffness were collected from 10 irradiated LD flap breast reconstruction patients, 14 two-stage subpectoral implant reconstruction patients (subpectoral), and 10 irradiated deep inferior epigastric perforator (DIEP) flap patients an average of 659 days post-reconstruction. Read More

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http://dx.doi.org/10.1007/s10549-018-5003-8DOI Listing
October 2018

Intraoperative superficial inferior epigastric vein preservation for venous compromise prevention in breast reconstruction by deep inferior epigastric perforator flap.

Ann Chir Plast Esthet 2018 Oct 13. Epub 2018 Oct 13.

Plastic, Reconstructive and Aesthetic Surgery Department, AP-HP, hôpital Saint-Louis, 1, avenue Claude-Vellefaux, 75010 Paris, France.

Objective: The aim of this study was to analyze our technique of intraoperative venous compromise management based on conservation of the superficial inferior epigastric vein (SIEV), and to undertake a retrospective review of our series of breast reconstructions by deep inferior epigastric perforator (DIEP) flap, followed by a review of other techniques reported in the literature.

Materials And Methods: This retrospective study involves 198 breast reconstructions by DIEP flap performed between January 2010 and September 2017. Our surgical technique is related in detail, with a focus on venous compromise management. Read More

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http://dx.doi.org/10.1016/j.anplas.2018.09.004DOI Listing
October 2018

Variation in the perioperative care of women undergoing abdominal-based microvascular breast reconstruction in the United Kingdom (The optiFLAPP Study).

Authors:

J Plast Reconstr Aesthet Surg 2019 Jan 25;72(1):35-42. Epub 2018 Aug 25.

Introduction: Abdominal-based microvascular breast reconstruction constitutes approximately one-fifth of reconstructions following mastectomy for breast cancer. Enhanced recovery after surgery (ERAS) protocols have been implemented to improve patient care. The aim of this project was to identify variation in the perioperative care of women undergoing microvascular breast reconstruction to inform development of an ERAS protocol. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S17486815183029
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http://dx.doi.org/10.1016/j.bjps.2018.08.007DOI Listing
January 2019
2 Reads

Salvage mastectomy for local recurrence and second ipsilateral autologous breast reconstruction using a perforator flap from a different donor site.

Case Reports Plast Surg Hand Surg 2018 25;5(1):54-58. Epub 2018 Sep 25.

Department of Plastic and Reconstructive Surgery, Yokohama City University Hospital, Yokohama, Japan.

Only one case of second ipsilateral autologous reconstruction for the same breast that had previously undergone reconstruction has been reported. Here we present a patient who underwent breast reconstruction twice using free flap from different donor sites, using a buttock after a local recurrence following the previous reconstruction with a lower abdomen. Read More

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http://dx.doi.org/10.1080/23320885.2018.1515020DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6161600PMC
September 2018
13 Reads

[To harvest a SIEA flap instead of a DIEP flap in breast reconstruction: A technical note].

Ann Chir Plast Esthet 2018 Sep 27. Epub 2018 Sep 27.

Service de chirurgie plastique, reconstructrice et esthetique, hôpital de la Conception, Assistance publique-Hôpitaux de Marseille, 147, boulevard Baille, 13005 Marseille, France.

Breast reconstruction by abdominal flap has evolved to ensure minimal donor-site morbidity with the description of Deep Inferior Epigastric artery Perforator flap (DIEP flap). Being of the same thickness and the same surface, the Superficial Inferior Epigastric Artery flap (SIEA flap) does not require, for it harvesting, to open the abdominal fascia or to dissect through the muscles minimizing again donor-site sequelae. However, it is little used because of the variability of its vascularization and a higher failure rate than the DIEP in the literature. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S02941260183014
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http://dx.doi.org/10.1016/j.anplas.2018.08.007DOI Listing
September 2018
1 Read

Quality of Life of Patients After Immediate or Delayed Autologous Breast Reconstruction: A Multicenter Study.

Ann Plast Surg 2018 Nov;81(5):523-527

From the Departments of Plastic and Reconstructive Surgery, and.

Introduction: It is known that breast reconstruction improves quality of life (QoL) in women who underwent mastectomy. Previous studies showed that autologous immediate breast reconstruction is as safe as delayed breast reconstruction. However, there is not much known about the influence of the timing of the breast reconstruction on QoL. Read More

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http://dx.doi.org/10.1097/SAP.0000000000001618DOI Listing
November 2018
1 Read

Secondary breast reconstruction after mastectomy using the DIEP flap.

Surg Oncol 2018 Sep 26;27(3):513. Epub 2018 Jun 26.

Department of Plastic and Hand Surgery, University Hospital of Erlangen, Erlangen, Germany; Interdisciplinary Breast Center, University Hospital of Erlangen, Erlangen, Germany.

Introduction: Breast reconstruction is an important element in the successful therapy of breast cancer [1]. Thereby, autologous microvascular breast reconstruction has been shown to be a reliable technique. The use of a deep inferior epigastric perforator (DIEP) flap or a muscle-sparing (MS) free transverse rectus abdominis musculocutaneous (TRAM) flap is recognized in many centres as gold standard for reconstructive options [2-4]. Read More

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http://dx.doi.org/10.1016/j.suronc.2018.06.006DOI Listing
September 2018

[Autologous microsurgical breast reconstruction by free perforator flap at the expense of the Profund Femoral Artery (PAP): Harvest technique, modeling and results].

Ann Chir Plast Esthet 2018 Nov 10;63(5-6):473-485. Epub 2018 Sep 10.

Service de chirurgie plastique, reconstructrice et esthétique, hôpital européen Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France; Université Paris Descartes, 15, rue de l'École de Médecine, 75005 Paris, France.

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http://dx.doi.org/10.1016/j.anplas.2018.08.006DOI Listing
November 2018

Nipple-sparing mastectomy and breast reconstruction with a deep inferior epigastric perforator flap using thoracodorsal recipient vessels and a low lateral incision.

J Surg Oncol 2018 Sep 13;118(4):621-629. Epub 2018 Sep 13.

Division of Reconstructive Microsurgery, Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Chang Gung University, College of Medicine, Taoyuan, Taiwan.

Background: Nipple-sparing mastectomy poses challenges in providing esthetically-pleasing immediate autologous breast reconstruction. This study was to investigate the outcomes of nipple-sparing mastectomy with breast reconstruction using free abdominal flaps between two different recipient sites.

Methods: Between 2010 and 2016, 79 patients who underwent nipple-sparing mastectomy with autologous breast reconstruction using thoracodorsal (TD) vessels in 30 cases or internal mammary (IM) vessels in 49 cases were investigated. Read More

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http://dx.doi.org/10.1002/jso.25204DOI Listing
September 2018
4 Reads

Two successful cases of DIEP flaps for breast reconstruction in patients with Factor V Leiden.

J Surg Case Rep 2018 Sep 6;2018(9):rjy231. Epub 2018 Sep 6.

Institute for Reconstructive Surgery, Houston Methodist Hospital, Weill Cornell Medicine, Houston, TX, USA.

Factor V Leiden (FVL) is the most common inherited hypercoagulable condition. It is a genetic disorder caused by a missense mutation that prevents inactivation of Factor V in the clotting cascade, leading to overproduction of thrombin and excess clotting. This pathophysiological process is especially unfavorable in patients undergoing free tissue transfer. Read More

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https://academic.oup.com/jscr/article/doi/10.1093/jscr/rjy23
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http://dx.doi.org/10.1093/jscr/rjy231DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6126179PMC
September 2018
8 Reads

The Stacked Hemiabdominal Extended Perforator Flap for Autologous Breast Reconstruction.

Plast Reconstr Surg 2018 Dec;142(6):1424-1434

Maastricht, The Netherlands; New York and Mt. Kisco, N.Y.; New Orleans, La.; and Hackensack, N.J. From the Department of Plastic, Reconstructive and Hand Surgery, and the GROW-School for Oncology and Developmental Biology, Maastricht University Medical Center; the Department of Plastic Surgery, New York Eye and Ear Infirmary at Mt. Sinai; the Division of Plastic Surgery, Northern Westchester Hospital; the Division of Plastic Surgery, Louisiana State University Health Sciences Center; and the Department of Plastic Surgery, Hackensack University Medical Center.

Background: Options for bilateral autologous breast reconstruction in thin women are limited. The aim of this study was to introduce a novel approach to increase abdominal flap volume with the stacked hemiabdominal extended perforator (SHAEP) flap. The authors describe the surgical technique and analyze their results. Read More

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http://dx.doi.org/10.1097/PRS.0000000000005058DOI Listing
December 2018
1 Read

[Autologous breast reconstruction by deep inferior epigastric free flap: Classic and minimally invasive extraperitoneal approaches].

Ann Chir Plast Esthet 2018 Nov 7;63(5-6):457-472. Epub 2018 Sep 7.

Université Paris Descartes, 15, rue de l'École-de-Médecine, 75005 Paris, France.

Perforator free flaps allow breast reconstructions « like with like » with skin and fat, excluding mammary gland, with a low morbidity. Those autologous reconstructions prevent material associated infections, capsular contracture and implant replacements, associated to breast reconstructions including implants. DIEP flap was described in 1994 to reduce the morbidity faced with TRAM flaps harvest. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S02941260183014
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http://dx.doi.org/10.1016/j.anplas.2018.08.004DOI Listing
November 2018
2 Reads

Advancements in imaging technology for microvascular free tissue transfer.

J Surg Oncol 2018 Oct 9;118(5):729-735. Epub 2018 Sep 9.

Department of Plastic Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas.

The use of preoperative imaging has become routine for many reconstructive microsurgeons to help localize perforators for planning of microvascular free flaps. However, with advancements in imaging technology, perforator mapping represents only one potential benefit as virtual planning and medical modeling, and flap tissue perfusion are also rapidly becoming commonplace and the standard of care for many surgeons who perform high-volume free flap reconstruction for the breast, head and neck, torso, and the extremities. Read More

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http://dx.doi.org/10.1002/jso.25194DOI Listing
October 2018
1 Read

Predicting venous congestion before DIEP breast reconstruction by identifying atypical venous connections on preoperative CTA imaging.

Microsurgery 2018 Sep 5. Epub 2018 Sep 5.

Department of Plastic Surgery, Southmead Hospital, Bristol, United Kingdom.

Background: Venous congestion is the principle cause of flap failure after microsurgical breast reconstruction. We aim to correlate preoperative computed tomography angiography (CTA) findings with postoperative venous congestion to predict patients at risk of congestion.

Methods: All patients undergoing deep inferior epigastric perforator (DIEP) breast reconstruction between August 2009 and August 2013 underwent preoperative CTA and prospectively entered the study. Read More

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http://dx.doi.org/10.1002/micr.30367DOI Listing
September 2018
1 Read

Factors that predict deep inferior epigastric perforator flap donor site hernia and bulge.

J Plast Surg Hand Surg 2018 Sep 4:1-5. Epub 2018 Sep 4.

a Department of Plastic and Reconstructive Surgery , Imperial College Hospital NHS Trust , London , UK.

Deep inferior epigastric artery perforator (DIEP) flap has become the gold standard in autologous breast reconstruction. Attention is now being focused on the impact of DIEP flap harvest technique on abdominal hernia rates. The aim of this study was to evaluate DIEP abdominal wall morbidity in relation to flap harvest and fascial closure technique. Read More

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https://www.tandfonline.com/doi/full/10.1080/2000656X.2018.1
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http://dx.doi.org/10.1080/2000656X.2018.1498790DOI Listing
September 2018
7 Reads

Perioperative nursing for immediate breast reconstruction with deep inferior epigastric perforator flap after breast cancer resection.

J Thorac Dis 2018 Jul;10(7):4017-4022

Operating Room, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, China.

Background: To investigate the value of the nursing cooperation workflow for immediate breast reconstruction with deep inferior epigastric perforator (DIEP) flap after breast cancer resection.

Methods: The clinical data of 29 patients who had undergone immediate breast reconstruction with DIEP flap after breast cancer resection in our center from January 2016 to December 2017 were retrospectively analyzed. In particular, the nursing cooperation workflow was reviewed. Read More

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http://jtd.amegroups.com/article/view/22737/17422
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http://dx.doi.org/10.21037/jtd.2018.07.58DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6105942PMC
July 2018
12 Reads

DIEAP Flap Breast Reconstruction Followed by Local Recurrence of Breast Cancer.

Case Rep Oncol 2018 May-Aug;11(2):493-498. Epub 2018 Jul 16.

Department of Surgery, Canisius-Wilhelmina Hospital, Nijmegen, the Netherlands.

Local recurrence after an autologous breast reconstruction is uncommon. We describe 2 patients with local recurrence 3 and 9 years, respectively, after mastectomy with DIEAP (deep inferior epigastric artery perforator) flap breast reconstruction. Patients generally present with a palpable mass, pain, or other visible abnormalities. Read More

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http://dx.doi.org/10.1159/000490940DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6103338PMC
July 2018
3 Reads

[Breast reconstruction with the free TRAM or DIEP flap – What is the current standard? Consensus Statement of the German Speaking Working Group for Microsurgery of the Peripheral Nerves and Vessels].

Handchir Mikrochir Plast Chir 2018 08 21;50(4):248-255. Epub 2018 Aug 21.

BG Unfallklinik Ludwigshafen, Klinik für Hand, Plastische und Rekonstruktive Chirurgie, Schwerbrandverletztenzentrum.

The most common donor-site for autologous breast reconstruction is the abdomen. Over the past several decades technical advances have resulted in the development of flaps that have been associated with a progressive decrease in abdominal wall morbidity. However, controversy exists related to the differences between muscle-sparing (MS)-TRAM and deep inferior epigastric perforator (DIEP) flaps. Read More

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http://dx.doi.org/10.1055/a-0631-9025DOI Listing
August 2018
1 Read

[Effectiveness of internal mammary artery perforator propeller flap repair combined with radiotherapy for chest keloid in female patients].

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2018 09;32(9):1196-1200

Department of Plastic Surgery, West China Hospital, Sichuan University, Chengdu Sichuan, 610041,

Objective: To investigate the effectiveness of internal mammary artery perforator (IMAP) propeller flap repair combined with radiotherapy for chest keloid in female patients.

Methods: Between January 2015 and December 2016, 15 female patients with chest keloids were treated, aged 28-75 years (mean, 45.2 years). Read More

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http://dx.doi.org/10.7507/1002-1892.201803004DOI Listing
September 2018
2 Reads

[Effectiveness of posterior intercostal artery perforator flap in repair of donor defect after latissimus dorsi myocutaneous flap transfer].

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2018 09;32(9):1187-1191

Department of Burn &  Plastic and Hand &  Foot Surgery, the Second Hospital of Yulin City , Yulin Shaanxi, 719000, P.R.China.

Objective: To investigate the feasibility and effectiveness of the latissimus dorsi myocutaneous flap in repair of large complex tissue defects of limb and the relaying posterior intercostal artery perforator flap in repair of donor defect after latissimus dorsi myocutaneous flap transfer.

Methods: Between January 2016 and May 2017, 9 patients with large complex tissue defects were treated. There were 8 males and 1 female with a median age of 33 years (range, 21-56 years). Read More

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http://dx.doi.org/10.7507/1002-1892.201803046DOI Listing
September 2018
2 Reads

The effect of postoperative closed incision negative pressure therapy on the incidence of donor site wound dehiscence in breast reconstruction patients: DEhiscence PREvention Study (DEPRES), pilot randomized controlled trial.

J Tissue Viability 2018 Nov 14;27(4):262-266. Epub 2018 Aug 14.

Department of Plastic and Reconstructive Surgery, Radboud University Medical Center, P/O Box 9101, 6500 HB, Nijmegen, The Netherlands. Electronic address:

Aim: Wound dehiscence is a serious postoperative complication associated both with high morbidity and mortality. It has a significant rate of occurrence in breast reconstruction surgeries with a deep internal epigastric perforator (DIEP) and with a profunda artery perforator (PAP) flap. Risk factors for wound dehiscence include smoking, diabetes mellitus, chronic obstructive pulmonary disease, and obesity. Read More

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http://dx.doi.org/10.1016/j.jtv.2018.08.005DOI Listing
November 2018

Unilateral Autologous Breast Reconstruction with Bi-pedicled, Conjoined Deep Inferior Epigastric Perforator Flaps.

J Reconstr Microsurg 2018 Aug 15. Epub 2018 Aug 15.

Division of Plastic and Reconstructive Surgery, Department of Surgery, Greenwich Hospital, Greenwich, Connecticut.

Background:  The abdomen remains the most popular and reliable donor site for autologous breast reconstruction. Some patients, however, lack sufficient tissue to recreate an aesthetic breast mound using a single-pedicle, deep inferior epigastric perforator (DIEP) flap, particularly when matching a contralateral native breast. The amount of abdominal skin and/or soft tissue reliably supplied by one vascular pedicle is frequently insufficient to adequately restore the breast skin envelope and "footprint. Read More

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http://dx.doi.org/10.1055/s-0038-1668161DOI Listing
August 2018
1 Read

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
1 Read