1,846 results match your criteria Breast Reconstruction Perforator Flap


Flap to Mastectomy Mass: Are Higher Ratios Associated with Greater Breast Reconstruction Satisfaction?

J Reconstr Microsurg 2022 Jun 25. Epub 2022 Jun 25.

Yale University School of Medicine, New Haven, United States.

Background: Autologous breast reconstruction is associated with superior patient-reported outcomes compared to prosthetic techniques, but little is known about the relationship between autologous flap mass and patient satisfaction. We hypothesized that a higher differential mass (ratio of flap mass to mastectomy mass) would be associated with greater satisfaction with reconstruction.

Methods: In this retrospective study, patients who underwent autologous breast reconstruction between 2015 and 2020 with a deep inferior epigastric perforator (DIEP) flap completed the BREAST-Q survey. Read More

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Importance of Incidental Findings in Preoperative Computed Tomography Angiography for Abdominal-Based Free Flap Breast Reconstruction: A Multi-institutional Study.

Plast Reconstr Surg 2022 Jun 24. Epub 2022 Jun 24.

Division of Plastic and Reconstructive Surgery, University of Colorado Anschutz Medical Campus, Aurora, CO.

Background: Besides its intended purpose of perforator mapping, CTA can also identify incidental findings that may require further evaluation. In this multi-institutional study, we evaluated the frequency of incidental findings and their significance and impact on treatment course. We also aimed to identify risk factors for detecting such findings. Read More

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Anterograde Injection of Alteplase Salvages Deep Inferior Epigastric Perforator Flap in Reconstructive Breast Surgery.

Plast Reconstr Surg Glob Open 2022 Jun 20;10(6):e4415. Epub 2022 Jun 20.

Department of Plastic, Aesthetic and Reconstructive Surgery, Hospital of St. John of God Salzburg, Paracelsus Medical University Salzburg, Salzburg, Austria.

The DIEP flap is currently considered the gold standard for autologous reconstructive breast surgery. Postoperative flap failure due to microvascular postanastomotic thrombotic occlusion is a rare but severe complication. Alteplase, a thrombolytic agent typically used in the setting of an ischemic stroke, myocardial infarction, or pulmonary embolism, has also been injected into the microcirculation of flaps as a rescue procedure due to imminent flap loss. Read More

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Use of Serial Flap Transfer Technique in En Bloc Reconstruction of Extensive Soft Tissue Defects in the Head and Neck.

J Craniofac Surg 2022 May 12;33(3):809-813. Epub 2021 Apr 12.

Department of Plastic and Reconstructive Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Shijingshan District, Beijing, china.

Abstract: En bloc reconstruction of extensive head and neck defects is feasible with matched tissue from the medial arm or chest. Nevertheless, the donor site faces significant morbidity following massive cutaneous flap harvesting. The serial flap transfer technique can increase the reconstructive ability of these flaps and minimize the donor site morbidity. Read More

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Pyoderma gangrenosum after deep inferior epigastric perforator flap: How prompt diagnosis and treatment can avoid surgical debridement and further morbidity.

JPRAS Open 2022 Sep 16;33:42-46. Epub 2022 May 16.

Department of Surgery, Division of Plastic Surgery - Institute for Reconstructive Surgery, Houston Methodist Hospital, Weill Cornell Medicine, Houston, TX, United States.

Pyoderma gangrenosum (PG) is a skin disorder characterized by painful, enlarging necrotic ulcers with bluish borders surrounded by advancing zones of erythema. The key histologic feature is neutrophilic infiltration of the superficial and deep layers of the dermis and the absence of microorganisms. Although rare and associated with autoimmune diseases such as rheumatoid arthritis, ulcerative colitis and Crohn's disease, the diagnosis is commonly missed at presentation and patients are often treated for infection with antibiotics and surgical debridement. Read More

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September 2022

Chest wall perforator flap to partially reconstruct central mound of breast tissue - evolution of the technique.

J Surg Case Rep 2022 Jun 16;2022(6):rjac276. Epub 2022 Jun 16.

Department of Breast Surgery, Lancashire Teaching Hospitals NHS Foundation Trust, Chorley, UK.

We describe the use of chest wall perforator flap (CWPF) to reconstruct the central mound of breast tissue in women presenting with central/retro areolar breast cancer. We describe the results of seven patients (median age, 59 years) with a median follow-up of 9 months. We were able to conserve the breast in all except one woman who was found to have extensive DCIS. Read More

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Increased Opioid Consumption following DIEP Flap Breast Reconstruction: Effect of Depression and Anxiety.

J Reconstr Microsurg 2022 Jun 17. Epub 2022 Jun 17.

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

Introduction:  Enhanced Recovery After Surgery (ERAS) protocols have decreased postoperative opioid consumption and hospital length of stay in deep inferior epigastric perforator (DIEP) flap breast reconstruction. We aim to evaluate whether there needs to be further adjustments to best improve outcomes specifically in patients with a preexisting psychiatric condition.

Methods:  A retrospective review was performed of all patients that underwent DIEP flap breast reconstruction between October 2018 and September 2020. Read More

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Perforator Characteristics and Impact on Postoperative Outcomes in DIEP Flap Breast Reconstruction: A Systematic Review and Meta-Analysis.

J Reconstr Microsurg 2022 Jun 17. Epub 2022 Jun 17.

Department of Plastic and Reconstructive Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland.

Background:  High-quality evidence on perforator selection in deep inferior epigastric perforator (DIEP) flap harvesting is lacking, making preoperative planning and choice of perforators "surgeon-specific." This lack of consensus is a subject of continuous debate among microsurgeons. We aimed to systematically review perforator characteristics and their impact on DIEP flap breast reconstruction outcomes. Read More

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[Role of intercostal neurovascular perforator in lower abdominal flap].

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2022 Jun;36(6):770-775

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

Objective: To investigate if intercostal neurovascular perforator can nourish lower abdominal flap.

Methods: Between June 2017 and December 2020, in 39 female patients with predominant perforator originated from intercostal nerve nutrient vessels, main trunk of the deep inferior epigastric vessels was chosen to be the pedicle to harvest free lower abdominal flap for breast reconstruction. The age of the patients ranged from 28 to 52 years, with an average of 38. Read More

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Cost-volume analysis of deep inferior epigastric artery perforator flaps for breast reconstruction in the United States.

Surgery 2022 Jun 14. Epub 2022 Jun 14.

Cardiovascular Outcomes Research Laboratories, Division of Cardiac Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA. Electronic address:

Background: Deep inferior epigastric artery perforator flaps are increasingly utilized over other autologous methods of breast reconstruction. We evaluated the relationship between annual hospital volume and costs after breast reconstruction with the deep inferior epigastric artery perforator flap.

Methods: All female patients undergoing elective implant or autologous tissue breast reconstruction were identified using the 2016-2019 Nationwide Readmission Database. Read More

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Long-Term Patient Satisfaction and Quality of Life Following Breast Reconstruction Using the BREAST-Q: A Prospective Cohort Study.

Front Oncol 2022 23;12:815498. Epub 2022 May 23.

Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan.

Background: Breast reconstruction is a promising surgical technique to improve health-related quality of life (HRQoL) in patients with breast cancer. However, the long-term risk factors associated with HRQoL after breast surgery are still unclear. Our aim was to evaluate breast satisfaction and HRQoL following breast reconstruction to identify clinical factors associated with each domain of BREAST-Q in the long-term. Read More

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Surgical Delay-Induced Hemodynamic Alterations of the Superficial Inferior Epigastric Artery Flap for Autologous Breast Reconstruction.

Ann Plast Surg 2022 06;88(5 Suppl 5):S414-S421

Division of Plastic and Reconstructive Surgery, Louisiana State University Health Sciences Center.

Background: The superficial inferior epigastric artery (SIEA) flap allows transfer of tissue without violating the rectus fascia. Traditionally it is best used in single stage reconstruction when vessel caliber is 1.5 mm; 56% to 70% of SIEAs are less than 1. Read More

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A Comparative Study of Drain in Oncoplastic Breast Conserving Surgery (Therapeutic Mammaplasty and Chest Wall Perforator Flap Partial Breast Reconstruction) vs. Mastectomy.

Clin Breast Cancer 2022 May 6. Epub 2022 May 6.

Cambridge University Hospitals, Breast Unit, Cambridge Biomedical Research Centre, Cambridge, United Kingdom. Electronic address:

Background: Increasingly, breast surgery is same day or 23-hour day-case surgery. Discharge criteria need to ensure patient safety outside hospital. We explore some of the evolving day-case factors in oncoplastic breast surgery (OBS). Read More

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FlapMap Visual Language System for Vascular Imaging Prior to Microvascular Free Tissue Transfer.

Plast Reconstr Surg Glob Open 2022 Jun 2;10(6):e4351. Epub 2022 Jun 2.

Division of Plastic and Reconstructive Surgery, Icahn School of Medicine at Mount Sinai, New York, N.Y.

Preoperative vascular imaging has been shown to be beneficial before free tissue transfer procedures, especially for deep inferior epigastric perforator flap breast reconstruction. Although computerized tomography angiography and magnetic resonance angiogram are increasingly frequently performed, there is no standardized method for recording, analyzing, and communicating the vast amount of clinically relevant information that is obtained from these tomographic imaging studies. Herein, the authors propose a new visual language system for preoperative imaging called "FlapMap," which allows for the creation of a clinically actionable, easily understood, and easily communicated single image that aids in preoperative planning before microvascular free tissue transfer. Read More

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Early venous congestion after diep flap breast reconstruction: case report of a successful management.

Acta Biomed 2022 Jun 7;93(S1):e2022180. Epub 2022 Jun 7.

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Background And Aim: More than 250 000 women estimated to be diagnosed with breast cancer in the USA every year. Mastectomy is primary treatment for more than a third of those with early-stage disease. Most of the patients undergoing mastectomy receive breast reconstruction. Read More

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Deep inferior epigastric perforator flap preoperative planning: A comparative analysis between dynamic infrared thermography, computerized tomography angiography, and hand-held Doppler.

Microsurgery 2022 Jun 6. Epub 2022 Jun 6.

Clinic of Plastic Surgery, Department of Neuroscience, Padua University Hospital, Padua, Italy.

Introduction: Hand-held Doppler (HHD) sonography and computerized tomography angiography (CTA) are the common assessment tools for deep inferior epigastric perforator (DIEP) flap preoperative planning. CTA is considered the gold standard method for preoperative perforator mapping but necessitates contrast medium and X-ray exposure. Dynamic infrared thermography (DIRT) does not have these drawbacks and allows the detection of hot and cold spots on a given body area. Read More

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Computational Fluid Dynamic Evaluation of Deep Inferior Epigastric Artery Perforator (DIEP) Flap End-to-Side Anastomosis.

Cureus 2022 May 1;14(5):e24650. Epub 2022 May 1.

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

Background End-to-side (ETS) microvascular anastomoses are utilized within deep inferior epigastric artery perforator (DIEP) flap breast reconstruction procedures. Optimization of these anastomoses via a computational fluid dynamic (CFD) model can minimize ischemia and contribute to flap success. Methods  A CFD model of a deep inferior epigastric artery to internal mammary artery anastomosis was constructed with OpenFOAM software (OpenCFD Ltd. Read More

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TUG flap breast reconstruction; a 5-year consecutive case series of patient reported outcomes.

Plast Reconstr Surg 2022 Jun 3. Epub 2022 Jun 3.

Department of Plastic Surgery, Queen Victoria Hospital, Holtye Road, East Grinstead, UK.

The Transverse Upper Gracilis (TUG) flap is an important reconstructive option for patients who desire autologous reconstruction after mastectomy but in whom a Deep Inferior Epigastric Perforator (DIEP) flap is unavailable or undesirable. We present an analysis of outcomes and patient satisfaction results, from a consecutive series in a single institution.

Method: Using a prospectively populated free-flap database, all patients undergoing TUG flap breast reconstruction for a mastectomy defect between January 2013 and December 2017 were identified. Read More

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Deep inferior epigastric perforator (DIEP) flap safety profile in slim versus non-slim BMI patients: A systematic review and meta-analysis.

J Plast Reconstr Aesthet Surg 2022 Apr 30. Epub 2022 Apr 30.

Department of Plastic and Reconstructive Surgery, Concord Hospital, Sydney, New South Wales, Australia.

Background/purpose: The complications of breast reconstruction using deep inferior epigastric perforator (DIEP) flaps in non-slim patients are well recognized. However, the effects of this surgery performed on slim patients are yet to be consolidated. This study aims to compare the outcomes of performing DIEP flap breast reconstruction in slim and non-slim body mass index (BMI) patients. Read More

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Evaluating the accuracy of three-dimensional surface-imaging for circumference analysis of the thigh.

J Plast Reconstr Aesthet Surg 2022 Apr 25. Epub 2022 Apr 25.

From the Department of Plastic, Reconstructive and Hand Surgery, Radboud University Medical Centre (Radboudumc), Geert Grooteplein Zuid 10, Nijmegen, the Netherlands.

Background: Three-dimensional (3D) surface-imaging is an increasingly popular and useful tool in surgical planning and evaluation. These systems are used for anthropometric measurements of the face, breast and upper extremity. Its accuracy has, however, not yet been evaluated for the thigh. Read More

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A comparative study between deep inferior epigastric artery perforator flap breast reconstruction and DIEP flap breast reconstruction coupled with vascularized lymph node transfer: Improving the quality of life of patients with breast cancer related lymphedema without affecting donor site outcomes.

Microsurgery 2022 May 30. Epub 2022 May 30.

Department of Plastic Surgery, University Hospitals of Coventry and Warwickshire, Coventry, UK.

Background: Despite simultaneous microvascular breast reconstruction (MBR) and vascularized lymph node transfer (VLNT) gaining wide popularity as a potential treatment for breast cancer related lymphedema (BCRL), there is a lack of evidence supporting the procedure. There are few reports in the literature, and no study has compared simple deep inferior epigastric artery perforator (DIEP) to simultaneous DIEP flap and VLNT.

Patients And Methods: A retrospective analysis of our series of DIEP flaps was conducted. Read More

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Improving the Safety of DIEP Flap Transplantation: Detailed Perforator Anatomy Study Using Preoperative CTA.

J Pers Med 2022 Apr 28;12(5). Epub 2022 Apr 28.

Laboratory for Tissue Engineering and Regenerative Medicine, Department of Plastic and Hand Surgery, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany.

Background: Deep inferior epigastric perforator and muscle sparing transverse rectus abdominis muscle flaps are commonly used flaps for autologous breast reconstruction. CT-angiography allows to analyse the perforator course preoperatively. Our aim was to compare the different aspects of perforator anatomy in the most detailed study. Read More

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Analysis of robot-assisted nipple-sparing mastectomy using the da Vinci SP system.

J Surg Oncol 2022 May 27. Epub 2022 May 27.

Department of Surgery, Yonsei University College of Medicine, Seoul, Korea.

Background: As patients tend to be diagnosed with breast cancer at an early stage, the demand for better cosmetic outcomes has increased. Several studies revealed that robot-assisted nipple-sparing mastectomy (RNSM) shows favorable outcomes. The aim of the study was to reveal the feasibility of RNSM using the da Vinci single-port (SP) system with a minimal incision, hidden in the arm. Read More

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Anomalous vascular perforator of the internal thoracic artery supplying a pedicled transverse rectus abdominis myocutaneous flap-a case report.

J Surg Case Rep 2022 May 23;2022(5):rjac135. Epub 2022 May 23.

Division of General Surgery, Kingston Public Hospital, Kingston, Jamaica.

The pedicled transverse rectus abdominis myocutaneous (TRAM) flap is an infrequently performed procedure relative to the more current microsurgical free tissue transfers in most centres around the world. However, in resource-limited centres where procedures requiring microsurgical intervention are rarely employed, the pedicled TRAM whose vascular axis is that of the superior epigastric artery, is an invaluable tool in the plastic surgeon's armamentarium both for breast reconstruction and chest wall soft tissue resurfacing. This a report of a case of variable anatomical vascular perforating branch of the internal thoracic artery, which was encountered while using a TRAM to resurface a chest wall defect after mastectomy was performed for locally advanced breast cancer. Read More

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Surgical and Patient Reported Outcomes After DIEP Breast Reconstruction at a Low-Volume Community Hospital Without Microvascular Fellowship Training.

Eplasty 2021 29;21:e9. Epub 2021 Sep 29.

Department of Plastic Surgery, Kaiser Permanente Moanalua Medical Center; Honolulu, HI.

Background: Microsurgical breast reconstruction is typically performed at large, academic centers by fellowship-trained surgeons. This study examines surgical and patient-reported outcomes (PROs) after deep inferior epigastric perforator (DIEP) flap breast reconstruction at a community hospital by surgeons without fellowship training.

Methods: A prospective clinical database and BREAST-Q results were obtained from 33 patients after 45 DIEP flaps performed between 2016 and 2020. Read More

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September 2021

Reconstruction of complex chest wall defects: A case report.

World J Clin Cases 2022 Apr;10(11):3505-3510

Department of Vascular, Thyroid, and Breast Surgery, Affiliated Hospital of Guangdong Medical University, Zhanjiang 524000, Guangdong Province, China.

Background: Chronic radiative chest wall ulcers are common in patients undergoing radiation therapy. If not treated early, then symptoms such as erosion, bleeding and infection will appear on the skin. In severe cases, ulcers invade the ribs and pleura, presenting a mortality risk. Read More

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Free flap transfer with supermicrosurgical technique for soft tissue reconstruction: A systematic review and meta-analysis.

Microsurgery 2022 May 12. Epub 2022 May 12.

Division of Plastic and Reconstructive Surgery, Strong Memorial Hospital, University of Rochester Medical Center, Rochester, New York, USA.

Background: Supermicrosurgery is a technique that allows microsurgeons to accomplish dissections and anastomoses of vessels and nerve fascicles with diameters of ≤0.8 mm. Considering the potential benefits of this technique and limited literature synthesizing the outcomes of supermicrosurgery, the aim of this study was to summarize the available evidence of reconstructive supermicrosurgery and to estimate the success rate. Read More

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Influence of the sentinel node outcome analysed by one-step nucleic acid amplification on the risk for postmastectomy radiation therapy and the scheduling of immediate breast reconstruction.

J Surg Oncol 2022 May 9. Epub 2022 May 9.

Department of Surgery, Zuyderland Medical Center, Sittard, The Netherlands.

Background: In patients with cT1-T3N0 breast cancer, postmastectomy radiation therapy (PMRT) is considered a contraindication for immediate breast reconstruction (IBR) due to a high risk of complications. The sentinel node biopsy (SNB) is an important determinant for PMRT. In this study, we evaluated the impact of SNB outcome on the planning of IBR after mastectomy. Read More

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New Method for Umbilicoplasty with Bilateral Square Flap and Caudal Deep Inferior Epigastric Artery Perforator Flap.

Eplasty 2022 12;22:e8. Epub 2022 Apr 12.

Yamato Municipal Hospital, Yamato-shi, Kanagawa, Japan.

Background: The navel is an important cosmetic feature of the abdomen. A vertically long navel with a deep caudal side has recently been preferred by patients. Currently, there is no plastic surgery technique for complete umbilical repositioning or plasty after umbilical keloid resection. Read More

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Thermal injury to a reconstructed breast.

Tidsskr Nor Laegeforen 2022 05 2;142(7). Epub 2022 May 2.

Seksjon for plastikk- og rekonstruktiv kirurgi, Universitetssykehuset Nord-Norge.

Background: Breast reconstruction using free flaps based on the lower abdominal tissue is a common procedure. Postoperatively, the blood supply and innervation of the flap will be altered due to denervation. The case presented here illustrates the resulting increased sensitivity to heat exposure. Read More

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