Flap Failure and Wound Complications in Autologous Breast Reconstruction: A National Perspective

Massenburg, Benjamin B.; Sanati-Mehrizy, Paymon; Ingargiola, Michael J.; Rosa, Jonatan Hernandez; Taub, Peter J.

doi:10.1007/s00266-015-0575-8

Cited by 49 publications

(48 citation statements)

References 24 publications

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“…Finally, 85% of respondents would not recommend riskreducing mastectomy for patients with BRCA deleterious mutations. These data agree with the recommendations to avoid or delay major surgery that could prolong hospitalization and increase complications or require further hospital admissions [46][47][48][49][50][51][52].…”

Section: Discussionsupporting

confidence: 85%

Management of early breast cancer during the COVID-19 pandemic in Brazil

Cavalcante

Novita²,

Millen

et al. 2020

Preprint

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Purpose: The COVID-19 pandemic has impacted early breast cancer (EBC) treatment worldwide. This study analyzed how Brazilian breast specialists are managing EBC. Methods: An electronic survey was conducted with members of the Brazilian Society of Breast Specialists between April 30 and May 11, 2020. Bivariate analysis was used to describe changes in how specialists managed EBC at the beginning and during the pandemic, according to molecular subtype and oncoplastic surgery. Results: The response rate was 34.4% (503/1,462 specialists). At the beginning of the pandemic, 43% changed their management approach. As the outbreak progressed, this proportion increased to 69.8% (p<0.001). For hormone receptor-positive tumors with the best prognosis (Ki67<20%), 47.9% and 17.7% of specialists would recommend neoadjuvant endocrine therapy for postmenopausal and premenopausal women, respectively. For tumors with poorer prognosis (Ki67>30%), 34% and 10.9% would recommend it for postmenopausal and premenopausal women, respectively. Menopausal status significantly affected whether the specialists changed their approach (p<0.00001). For tumors ≥1.0 cm, 42.9% of respondents would recommend neoadjuvant systemic therapy for triple-negative tumors and 39.6% for HER2+ tumors. Overall, 63.4% would recommend immediate total breast reconstruction, while only 3.4% would recommend autologous reconstruction. In breast-conserving surgery, 75% would recommend partial breast reconstruction; however, 54.1% would contraindicate mammoplasty. Furthermore, 84.9% of respondents would not recommend prophylactic mastectomy in cases of BRCA mutation.Conclusions: Important changes occurred in EBC treatment, particularly for hormone receptor-positive tumors, as the outbreak progressed in each region. Systematic monitoring could assure appropriate breast cancer treatment, mitigating the impact of the pandemic.

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Section: Discussionsupporting

confidence: 85%

Management of early breast cancer during the COVID-19 pandemic in Brazil

Cavalcante

Novita²,

Millen

et al. 2020

Preprint

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“…7–15 There was 1 patient (3%) who had fat necrosis but no flap loss in our study, but Kim et al 22 reported 14.2% of fat necrosis in their large Asian patient study, and Massenburg et al 23 reported that the prevalence of flap failure was 2.7% in TRAM flaps and 2.4% in free flaps for autologous breast reconstruction. 20 This might be because we had a small number of the patients in our study and all patients were nonsmokers.…”

Section: Discussionmentioning

confidence: 52%

Donor-Site Complications and Remnant of Rectus Abdominis Muscle Status after Transverse Rectus Abdominis Myocutaneous Flap Reconstruction

Chirappapha

Trikunagonvong

Prapruttam

et al. 2017

Plastic and Reconstructive Surgery - Global Open

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Background:Transverse rectus abdominis myocutaneous (TRAM) flap reconstruction after mastectomy in breast cancer patients has become one of the milestones in breast reconstruction. There are several techniques that have been used in an attempt to minimize untoward complications. We present the whole muscle with partial sheath-sparing technique that focuses on the anatomy of arcuate line and the closure of the anterior abdominal wall techniques with mesh and determine factors associated with its complications and outcomes.Methods:We retrospectively and prospectively review the results of 30 pedicled TRAM flaps that were performed between November 2013 and March 2016, focusing on outcomes and complications.Results:Among the 30 pedicled TRAM flap procedures in 30 patients, there were complications in 5 patients (17%). Most common complications were surgical-site infection (7%). After a median follow-up time of 15 months, no patient developed abdominal wall hernia or bulging in daily activities in our study, but 6 patients (20%) had asymptomatic abdominal wall bulging when exercised. Significant factors related to asymptomatic exercised abdominal wall bulging included having a body mass index of more than 23 kg/m2.Conclusion:Pedicled TRAM flap by using the technique of the whole muscle with partial sheath-sparing technique combined with reinforcement above the arcuate line with mesh can reduce the occurrence of abdominal bulging and hernia.

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“…Limitations can significantly impact activities of daily living and leisure time pursuits for the first 3 months, but function generally begins to return to baseline between 6 and 12 months postoperatively. 33 Abdominal flaps donor sites are accompanied by some degree of donor-site morbidity, which can include asymmetry, bulge, or hernia. The incidence of abdominal hernia following pedicled TRAM flap reconstruction is cited between 1.2% and 8.8%.…”

Section: Hazards and Costs Associated With Crrmmentioning

confidence: 99%

Contralateral risk reducing mastectomy in patients with sporadic breast cancer. Benefits and hazards

Boccardo

Gentilini

2016

European Journal of Surgical Oncology (EJSO)

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Flap Failure and Wound Complications in Autologous Breast Reconstruction: A National Perspective

Abstract: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

Cited by 49 publications

References 24 publications

Management of early breast cancer during the COVID-19 pandemic in Brazil

Management of early breast cancer during the COVID-19 pandemic in Brazil

Donor-Site Complications and Remnant of Rectus Abdominis Muscle Status after Transverse Rectus Abdominis Myocutaneous Flap Reconstruction

Contralateral risk reducing mastectomy in patients with sporadic breast cancer. Benefits and hazards

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