Bilateral Free Flap Breast Reconstruction Outcomes: Do Abdominal Scars Affect Bilateral Flaps?

Unukovych, Dmytro; Caterson, Edward J.; Carty, Matthew J.; Erdmann-Sager, Jessica; Halvorson, Eric G.; Caterson, Stephanie A.

doi:10.1097/gox.0000000000001493

Cited by 3 publications

(1 citation statement)

References 19 publications

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“…Unukovych et al found generally similar risk profiles but increased hematoma incidence at the recipient site in a cohort of women with prior c-sections who underwent abdominally based breast reconstruction compared with women without histories of c-sections. 29 However, despite our study's similar cohort size, demographics, and incidence of prior abdominal surgery, we did not find any significant associations between prior abdominal surgery and perioperative outcomes.…”

Section: Discussioncontrasting

confidence: 67%

Language Disparity Predicts Poor Patient-Reported Outcome and Follow-Up in Microsurgical Breast Reconstruction

Wang

Rothchild

et al. 2023

J Reconstr Microsurg

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Background Patients with limited English proficiency (LEP) have starkly different health care experiences compared with their English-proficient counterparts. The authors aim to examine the link between LEP and postoperative outcomes in patients undergoing microsurgical breast reconstruction. Methods A retrospective review of all patients who underwent abdominal-based microsurgical breast reconstruction at our institution between 2009 and 2019 was performed. Variables collected included patient demographics, language status, interpreter usage, perioperative complications, follow-up visits, and self-reported outcomes (Breast-Q). Pearson's χ 2 test, Student's t-test, odds ratio analysis, and regression modeling were used for analysis. Results A total of 405 patients were included. LEP patients comprised 22.22% of the overall cohort with 80% of LEP patients utilizing interpreter services. LEP patients reported significantly lower satisfaction with an abdominal appearance at the 6-month follow-up and lower physical and sexual well-being scores at the 1-year follow-up (p = 0.05, 0.02, 0.01, respectively). Non-LEP patients had significantly longer operative times (539.6 vs. 499.3 minutes, p = 0.024), were more likely to have postoperative donor site revisions (p = 0.05), and more likely to receive preoperative neuraxial anesthesia (p = 0.01). After adjusting for confounders, LEP stats was associated with 0.93 fewer follow-up visits (p = 0.02). Interestingly, compared with LEP patients who did not receive interpreter services, LEP patients who did had 1.98 more follow-up visits (p = 0.02). There were no significant differences in emergency room visits or complications between the cohorts. Conclusion Our findings suggest that language disparities exist within microsurgical breast reconstruction and underscore the importance of effective, language-conscious communication between surgeon and patient.

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Section: Discussioncontrasting

confidence: 67%

Language Disparity Predicts Poor Patient-Reported Outcome and Follow-Up in Microsurgical Breast Reconstruction

Wang

Rothchild

et al. 2023

J Reconstr Microsurg

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Extensive abdominal surgery and scar does not absolutely contraindicate bilateral flap harvest from the abdomen: A case report

Reid

Ferris

2021

International Journal of Surgery Case Reports

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Introduction This case reports a female patient with a history of multiple laparotomies including stoma formations and reversals, who underwent successful bilateral abdominal flap based breast reconstruction. It highlights that even complex and repeated abdominal surgery is not an absolute contraindication to this procedure. Presentation of case A 52-year-old female with a history of bilateral mastectomy and implant-based breast reconstruction presented with bilateral capsular contracture, wanting removal and alternative breast reconstruction. Her history of ulcerative colitis and multiple complex and extensive abdominal surgeries initially seemed to preclude bilateral abdominal flap harvest and the patient was referred on for another opinion. CT-angiography after the subsequent opinion identified adequate deep inferior epigastric artery perforators and successful bilateral abdomen-based flap reconstruction was performed. Discussion This is the first case report of successful bilateral abdomen-based flap harvest in a patient with 6 previous laparotomies including stoma formations and reversals. Conclusion Complex and extensive abdominal surgery is not an absolute contraindication to bilateral flap harvest from the abdomen. With accurate CT-angiography to guide pre-operative planning and meticulous surgery, safe flap harvest is possible.

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The Role of CT Angiography in Assessing Deep Inferior Epigastric Perforator Flap Patency in Patients With Pre-existing Abdominal Scars

Ngaage

Hamed

Oni

et al. 2019

Journal of Surgical Research

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Bilateral Free Flap Breast Reconstruction Outcomes: Do Abdominal Scars Affect Bilateral Flaps?

Abstract: Supplemental Digital Content is available in the text.

Cited by 3 publications

References 19 publications

Language Disparity Predicts Poor Patient-Reported Outcome and Follow-Up in Microsurgical Breast Reconstruction

Language Disparity Predicts Poor Patient-Reported Outcome and Follow-Up in Microsurgical Breast Reconstruction

Extensive abdominal surgery and scar does not absolutely contraindicate bilateral flap harvest from the abdomen: A case report

The Role of CT Angiography in Assessing Deep Inferior Epigastric Perforator Flap Patency in Patients With Pre-existing Abdominal Scars

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