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Unilateral immediate deep inferior epigastric artery perforator flap breast reconstruction following skin sparing mastectomy: A comparative study on revision surgeries to improve breast symmetry.
Atzeni, Matteo; Salzillo, Rosa; Haywood, Richard M; Persichetti, Paolo; Ribuffo, Diego; Figus, Andrea.
Afiliação
  • Atzeni M; Faculty of Medicine and Surgery, Department of Surgical Sciences, Plastic Surgery and Microsurgery Unit, University of Cagliari, University Hospital Duilio Casula, Cagliari, Italy.
  • Salzillo R; Department of Plastic, Reconstructive and Aesthetic Surgery, Campus Bio-Medico University of Rome, University Hospital Campus Bio-Medico, Rome, Italy.
  • Haywood RM; Norwich Medical School, University of East Anglia, Norfolk and Norwich University Hospital NHS Foundation Trust, Norwich, UK.
  • Persichetti P; Department of Plastic, Reconstructive and Aesthetic Surgery, Campus Bio-Medico University of Rome, University Hospital Campus Bio-Medico, Rome, Italy.
  • Ribuffo D; Department of Surgery, Plastic Surgery Unit, Sapienza University of Rome, Rome, Italy.
  • Figus A; Faculty of Medicine and Surgery, Department of Surgical Sciences, Plastic Surgery and Microsurgery Unit, University of Cagliari, University Hospital Duilio Casula, Cagliari, Italy.
Microsurgery ; 42(8): 766-774, 2022 Nov.
Article em En | MEDLINE | ID: mdl-35916342
BACKGROUND: The number of revision surgeries to improve breast asymmetry after deep inferior epigastric perforator (DIEP) flap breast reconstruction is still high worldwide with impact on both patients and healthcare systems. These procedures include fat grafting, contralateral breast symmetrization, scar revision, flap repositioning and remodeling. A previously published DIEP flap insetting algorithm has proven to be effective in selecting patient-tailored strategies to achieve excellent aesthetic outcomes. This study investigated whether this insetting algorithm was effective in reducing revision surgeries in patients undergoing SSM and immediate DIEP flap breast reconstruction to achieve the goal of a one-stage reconstruction. METHODS: This retrospective case-control study included 60 patients (group A) treated without the DIEP flap standardized insetting algorithm and 60 patients (group B) treated with the standardized insetting algorithm, which considers among its variables the type of breast to be reconstructed, abdominal tissue thickness, rotation due to harvesting side. Demographic data, operative data, complications and number of revision surgeries were recorded. RESULTS: One hundred and twenty primary and 106 revision surgeries were performed. Groups were homogenous for age (p = .32), body mass index (p = .77), flap weight (p = .7), operative time (p = .87) and early complications (p = .78). When excluding isolated nipple reconstruction from the revision surgeries, one-stage reconstruction was successfully performed in 26 patients in group A (43.3%) and 39 patients (65.0%) in group B, with a statistically significant difference between the groups (p = .003). CONCLUSIONS: The introduction of a standardized insetting algorithm for immediate unilateral DIEP flap breast reconstruction can be effective in reducing the number of revision surgeries for breast asymmetry, making a one-stage reconstruction an achievable and reliable target.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Tipo de estudo: Observational_studies Limite: Female / Humans Idioma: En Ano de publicação: 2022 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Tipo de estudo: Observational_studies Limite: Female / Humans Idioma: En Ano de publicação: 2022 Tipo de documento: Article