geoscience.net logo
+ Resolve Article
+ Follow Us
Follow on FacebookFollow on Facebook
Follow on TwitterFollow on Twitter

+ Translate
+ Subscribe to Site Feed
GeoScience Most Shared ContentMost Shared Content

Increased Flap Weight and Decreased Perforator Number Predict Fat Necrosis in DIEP Breast Reconstruction


, : Increased Flap Weight and Decreased Perforator Number Predict Fat Necrosis in DIEP Breast Reconstruction. Plastic and Reconstructive Surgery. Global Open 1(2): 1-7

Compromised perfusion in autologous breast reconstruction results in fat necrosis and flap loss. Increased flap weight with fewer perforator vessels may exacerbate imbalances in flap perfusion. We studied deep inferior epigastric perforator (DIEP) and muscle-sparing transverse rectus abdominis myocutaneous (MS-TRAM) flaps to assess this concept. Data from patients who underwent reconstruction with DIEP and/or MS-TRAM flaps between January 1, 2010 and December 31, 2011 (n = 123) were retrospectively reviewed. Patient demographics, comorbidities, intraoperative parameters, and postoperative outcomes were collected, including flap fat necrosis and donor/recipient site complications. Logistic regression analysis was used to examine effects of flap weight and perforator number on breast flap fat necrosis. One hundred twenty-three patients who underwent 179 total flap reconstructions (166 DIEP, 13 MS-TRAM) were included. Mean flap weight was 658 ± 289 g; 132 (73.7%) were single perforator flaps. Thirteen flaps (7.5%) developed fat necrosis. African American patients had increased odds of fat necrosis (odds ratio, 11.58; P < 0.001). Odds of developing fat necrosis significantly increased with flap weight (odds ratio, 1.5 per 100 g increase; P < 0.001). In single perforator flaps weighing more than 1000 g, six (42.9%) developed fat necrosis, compared to 14.3% of large multiple perforator flaps. Flaps with increasing weight have increased risk of fat necrosis. These data suggest that inclusion of more than 1 perforator may decrease odds of fat necrosis in large flaps. Perforator flap breast reconstruction can be performed safely; however, considerations concerning race, body mass index, staging with tissue expanders, perforator number, and flap weight may optimize outcomes.

US$19.90

PMID: 25289212

DOI: 10.1097/GOX.0b013e318294e41d


Other references

Mancuso, C.; Pistritto, G.; Tringali, G.; Grossman, A.B.; Preziosi, P.; Navarra, P., 1997: Evidence that carbon monoxide stimulates prostaglandin endoperoxide synthase activity in rat hypothalamic explants and in primary cultures of rat hypothalamic astrocytes. Carbon monoxide (CO) shares with nitric oxide (NO) the ability to modulate the release of hypophysiotropic peptides from rat hypothalamic explants. While both gases are believed to act as neural messengers in the brain via the activation of solubl...

Ivan, M.; Jui, P.; Hidiroglou, 1979: The effects of nitrilotriacetic acid on solubilities of zinc, copper, manganese, and iron in the stomach of sheep. Four sheep, each prepared with a rumen fistula and reetrant cannula in the proximal duodenum, were used to study the effects of ruminal administration of nitrilotriacetic acid on solubilities of zinc, copper, manganese, and iron in rumen and duode...

Maes, P.; Donadio-Andréi, S.; Louwagie, M.; Couté, Y.; Picard, G.; Lacoste, C.; Bruley, C.; Garin, Jérôme.; Ichai, P.; Faivre, J.; Jaquinod, M.; Brun, V., 2017: Introducing plasma/serum glycodepletion for the targeted proteomics analysis of cytolysis biomarkers. A major class of clinical biomarkers is constituted of intracellular proteins which are leaking into the blood following ischemia, exposure to toxic xenobiotics or mechanical aggression. Their ectopic presence in plasma/serum is an indicator of ti...

Bowen, B., 1992: CITES and scientists -- conservation in conflict. Marine Turtle Newsletter, 5-6 No. 58

Spotts R.A.; Holmes R.J.; Washington W.S., 1988: Sources of spores and inoculum concentrations related to postharvest decay of apple and pear. This study identified sources of fungal spores causing postharvest infection of pome fruit and established relationships between inoculum concentrations of Penicillium expansum and wet core rot of apple. Twenty-four of 35 picking bins contained pa...

Hamm, C.W.; Kuemmel, P.; Sudrow, A.; Goldmann, B.; Terres, W., 1994: Association between thrombotic activity and myocardial cell injury in patients with unstable angina. European Heart Journal 15(ABSTR SUPPL ): 40

López Martínez, P.; Algarín, H.; Beauchamp, V.E.; Lugo, C.; Ortiz, C.; Vega, M.; Velázquez, E.; Zayas, Y.; Santiago, A., 1987: How do elderly veterans who fail to keep outpatient clinic appointments differ from those who do not. The study asked how do elderly veterans who fail to keep appointments in the General Medicine and Surgery Out-Patient Clinics in the San Juan, VA Hospital differ from those who do not. Three hypothesis were formulated: 1. Elderly patients who fail...

Anonymous, 1998: Duchenne mouse knocked out by two blows. Clinical Genetics 53(3): 171-172

Woodman, N.; Timm, R.M.; Slade, N.A.; Doonan, T.J., 1996: Comparison of traps and baits for censusing small mammals in Neotropical lowlands. The ability of snap-traps, live traps and baits were tested in their ability to capture small mammals in a tropical forest environment in Peru. Snap-traps captured 3.5 times as many species as live traps, and so consequently captured more species...

Inhoffen, H.H.; Schoeller, W., 1965: In memoriam, Walter Schoeller. Arzneimittel-Forschung 15(12): 1475-1476