DIEP flap for breast reconstruction: Is abdominal fat thickness associated with post-operative complications?

Détails

ID Serval
serval:BIB_2A4B650AB33B
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
DIEP flap for breast reconstruction: Is abdominal fat thickness associated with post-operative complications?
Périodique
Journal of plastic, reconstructive & aesthetic surgery
Auteur(s)
Modarressi A., Müller C.T., Montet X., Rüegg E.M., Pittet-Cuénod B.
ISSN
1878-0539 (Electronic)
ISSN-L
1748-6815
Statut éditorial
Publié
Date de publication
08/2017
Peer-reviewed
Oui
Volume
70
Numéro
8
Pages
1068-1075
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: ppublish
Résumé
Some surgeons consider a high body mass index (BMI) or important abdominal fat excess as contraindications for breast reconstruction with free deep inferior epigastric perforator (DIEP) flap. This study aimed to identify factors associated with post-operative complications by using this type of flap, with an emphasis on BMI and abdominal subcutaneous fat thickness.
A retrospective chart review of 105 consecutive patients who underwent DIEP flap breast reconstruction at our institution was performed to assess post-operative complications. Among other risk factors, we specifically studied the influence of BMI and abdominal wall thickness on complication occurrence. Abdominal wall thickness was measured at 10 different points on the angio-computed tomography scan performed pre-operatively.
Median age was 49.8 years (range, 27-69); average BMI was 25.57 kg/m(2) (range, 18.07-41.91). Immediate breast reconstruction was performed for 35% of patients, and five patients (4.7%) underwent bilateral reconstruction. Twenty-six patients (24.8%) presented 29 post-operative complications; 12 concerned abdominal complications (delayed wound healing [n = 6] and seroma [n = 6]) and 17 were related to complications of the reconstructed breast (six minimal necrosis treated conservatively, eight minor necrosis requiring surgical debridement and three total flap loss). The complication rate was not correlated with increased BMI or abdominal wall thickness. The only factor that significantly predicts DIEP flap complications was pre-operative radiotherapy (odds ratio = 4.05; p = 0.03).
No significant correlation was observed between BMI of 25-35 kg/m(2) or abdominal wall thickness and post-operative complications of the donor site or DIEP flap. Therefore, these factors should not be considered as contraindication criteria.

Mots-clé
Adult, Aged, Body Mass Index, Breast/pathology, Computed Tomography Angiography, Female, Humans, Mammaplasty/adverse effects, Middle Aged, Necrosis, Perforator Flap/adverse effects, Perforator Flap/pathology, Postoperative Complications/etiology, Postoperative Complications/surgery, Radiotherapy/adverse effects, Reoperation, Retrospective Studies, Risk Factors, Subcutaneous Fat, Abdominal/anatomy & histology, Subcutaneous Fat, Abdominal/diagnostic imaging, Body mass index, Breast reconstruction, Complications, DIEP, Free flap, Obesity
Pubmed
Web of science
Création de la notice
22/06/2017 17:43
Dernière modification de la notice
20/08/2019 13:09
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