The Impact of Technical Innovations and Donor-Site Mesh Repair on Autologous Abdominal-Based Breast Reconstruction—A Retrospective Analysis
Abstract
:1. Introduction
2. Materials and Methods
2.1. Patients
2.2. CTA
2.3. Laser-Assisted ICG Fluorescence Angiography
2.4. Venous Coupler Anastomosis
2.5. Donor Site Closure
2.6. Statistics
3. Results
3.1. Complications at the Recipient Site
3.2. Complications at the Donor Site
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Number of patients | 396 |
Age at operation date (mean ± SD; range) [years] | 52 ± 9; 30–77 |
BMI (mean ± SD; range) [kg/m2] | 27 ± 4; 17–45 |
Number of flaps
| 447 140 (31%) 109 (25%) 192 (43%) 6 (1%) |
No. of Flaps | Age (Mean ± SD) | ||
---|---|---|---|
No technical innovation | 44 (9.8%) | 52.1 ± 9.4 | p = 0.98 |
Coupler anastomosis | 61 (13.7%) | 52.3 ± 8.2 | |
Coupler anastomosis + CTA | 134 (30%) | 51.8 ± 9.2 | |
Coupler anastomosis + CTA + ICG angiography | 208 (46.5%) | 52.0 ± 8.4 |
Type of Major Complication | No. of Cases (%) | Type of Minor Complication | No. of Cases (%) |
---|---|---|---|
Total flap loss | 13 (3.3) | Wound dehiscence | 12 (3.0) |
Partial flap loss | 5 (1.3) | Seroma | 4 (1.0) |
Venous thrombosis | 15 (3.8) | Infection | 2 (0.5) |
Arterial thrombosis | 10 (2.5) | Partial flap necrosis | 1 (0.3) |
Hematoma/bleeding | 15 (3.8) | ||
Infection | 9 (2.3) | ||
Seroma | 1 (0.3) |
Type of Major Complication | Total Flap Loss | Partial Flap Loss | Venous Thrombosis | Arterial Thrombosis | Hematoma/ Bleeding | Infection | Seroma |
---|---|---|---|---|---|---|---|
No. technical innovation | 3 (7.0%) | 0 (0%) | 3 (7.0%) | 1 (2.3%) | 2 (4.7%) | 1 (2.3%) | 0 (0%) |
Coupler anastomosis | 3 (4.9%) p = 0.69 | 1 (1.6%) p > 0.99 | 3 (4.9%) p = 0.69 | 1 (1.6%) p > 0.99 | 3 (4.9%) p > 0.99 | 4 (6.6%) p = 0.40 | 1 (1.6%) p > 0.99 |
Coupler anastomosis + CTA | 3 (2.2%) p = 0.34 | 4 (3.0%) p > 0.99 | 5 (3.7%) p = 0.70 | 3 (2.2%) p > 0.99 | 6 (4.5%) p > 0.99 | 2 (1.5%) p = 0.08 | 0 (0%) p = 0.31 |
Coupler anastomosis + CTA + ICG angiography | 4 (1.9%) p > 0.99 | 0 (0%) * p = 0.02 | 4 (1.9%) p = 0.32 | 5 (2.4%) p > 0.99 | 4 (1.9%) p = 0.20 | 2 (1.0%) p = 0.65 | 0 (0%) p > 0.99 |
Type of Major Complication | No. of Cases (%) | Type of Minor Complication | No. of Cases (%) |
---|---|---|---|
Abdominal hernia/bulging | 21 (5.3) | Abdominal hernia/bulging | 18 (4.5) |
Seroma | 13 (3.3) | Seroma | 56 (14.1) |
Infection | 9 (2.3) | Infection | 6 (1.5) |
Hematoma/bleeding | 4 (1.0) | Wound dehiscence | 61 (15.4) |
Umbilical necrosis | 19 (4.8) |
No. | Major Donor Site Complications | p Value | Minor Donor Site Complications | p Value | |
---|---|---|---|---|---|
MS0-TRAM
| 6 5 1 | 0 (0%) 0 (0%) 0 (0%) | -- | 0 (0%) 0 (0%) 0 (0%) | -- |
MS1-TRAM
| 149 131 18 | 28 (19%) 21 (16%) 7 (39%) | * p = 0.02 | 49 (33%) 48 (37%) 1 (6%) | ** p < 0.001 |
MS2-TRAM
| 84 45 39 | 9 (11%) 4 (9%) 5 (13%) | n.s. | 21 (25%) 13 (29%) 8 (21%) | n.s. |
DIEP
| 106 93 13 | 4 (4%) 3 (3%) 1 (8%) | n.s. | 28 (26%) 25 (27%) 3 (23%) | n.s. |
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Promny, T.; Huberth, P.; Müller-Seubert, W.; Promny, D.; Cai, A.; Horch, R.E.; Arkudas, A. The Impact of Technical Innovations and Donor-Site Mesh Repair on Autologous Abdominal-Based Breast Reconstruction—A Retrospective Analysis. J. Clin. Med. 2024, 13, 2165. https://doi.org/10.3390/jcm13082165
Promny T, Huberth P, Müller-Seubert W, Promny D, Cai A, Horch RE, Arkudas A. The Impact of Technical Innovations and Donor-Site Mesh Repair on Autologous Abdominal-Based Breast Reconstruction—A Retrospective Analysis. Journal of Clinical Medicine. 2024; 13(8):2165. https://doi.org/10.3390/jcm13082165
Chicago/Turabian StylePromny, Theresa, Paula Huberth, Wibke Müller-Seubert, Dominik Promny, Aijia Cai, Raymund E. Horch, and Andreas Arkudas. 2024. "The Impact of Technical Innovations and Donor-Site Mesh Repair on Autologous Abdominal-Based Breast Reconstruction—A Retrospective Analysis" Journal of Clinical Medicine 13, no. 8: 2165. https://doi.org/10.3390/jcm13082165