Indications and Controversies for Abdominally-Based Complete Autologous Tissue Breast Reconstruction

Murphy, Brian; Kerrebijn, Isabel; Farhadi, Jian; Masià, Jaume; Höfer, Stefan

doi:10.1016/j.cps.2017.08.007

Cited by 23 publications

(18 citation statements)

References 62 publications

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“…In the search of the best functional and aesthetic results, free tissue transfers have become the gold standard for many of the issues that arise in reconstructive surgery [31,32]. Clear examples of this are the deep inferior epigastric artery perforator flap in breast reconstruction [7,8] and the anterolateral thigh flap in head and neck reconstruction [6]. But the success of these techniques does not only depend on an adequate vascular suture, but also on a constellation of details that must be taken into account.…”

Section: Discussionmentioning

confidence: 99%

“…A two-team approach is usually chosen in reconstructive microsurgery, one will raise the flap and the other will set the recipient site where this is going to be transplanted [7]. Therefore, all the time spent planning disposition is properly invested.…”

Section: Basic Principles In Microsurgery 21 Ergonomymentioning

confidence: 99%

“…The microsurgical instruments have evolved from ophthalmology or jewellery material to extremely specific and precise tools [7]. The basic kit is not made up of too much surgical material.…”

Section: Basic Microsurgery Instruments Kitmentioning

confidence: 99%

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Basic Principles in Microvascular Anastomosis and Free Tissue Transfer

Vila¹,

Couto-González²,

Brea-García³

2020

Vascular Biology - Selection of Mechanisms and Clinical Applications

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Free tissue transfer pursues the best functional and aesthetic results in reconstructive surgery. As these techniques completely maximise the donor tissues' disposability, these treatments have become a first-line option in many situations. When the donor site is taken form the same patient, these surgeries are often referred to as autotransplants. Free tissue transfer sustains in microvascular anastomosis, which are defined by a vessel lumen diameter inferior to 3 mm. Particular attention to some details is important in these techniques, as, for example, to preclude any damage to the vessel walls or any leakage in the microvascular anastomosis. But the success of these techniques does not only depend on an adequate vascular suture, but also on a constellation of details that must be taken into account. These go from the availability of a trained team, to the ergonomics of the surgeon, through the scrupulous cleanliness of the surgical field.

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Section: Discussionmentioning

confidence: 99%

Section: Basic Principles In Microsurgery 21 Ergonomymentioning

confidence: 99%

See 1 more Smart Citation

Basic Principles in Microvascular Anastomosis and Free Tissue Transfer

Vila¹,

Couto-González²,

Brea-García³

2020

Vascular Biology - Selection of Mechanisms and Clinical Applications

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“…Moreover, donor area morbidity cannot be completely addressed with these procedures. (20)(21)(22) LD flap is a good alternative option for patients having obesity, diabetes, hypercoagulation, hypertension, and smoking history who are at high risk for TRAM flap reconstruction, or those at high risk for donor area morbidity due to previous abdominal surgery or flap complication risk (5,12). LD flap provides a reliable blood flow and has advantages like minimal donor area morbidity.…”

Section: Discussionmentioning

confidence: 99%

Delayed Breast Reconstruction with Latissimus Dorsi Myocutaneous Flap and Implant in Patients Undergoing Total Mastectomy

Baltu¹,

Aydin²

2018

Acta Oncol Tur.

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Bu çalışmamızda total mastektomi uygulanan hastalarda latissimus dorsi kas deri flebi + implant ile geç dönem meme rekonstrüksiyonu yapılan hastalar incelenip estetik sonuçların ve komplikasyonların değerlendirilmesi amaçlanmıştır. YÖNTEM ve GEREÇLER: Bu çalışmaya latissimus dorsi kas-deri flebi ve implant ile geç dönem rekonstrüksiyon uygulanan total mastektomili hastalar dahil edildi. BULGULAR: 2013-2018 yılları arasında toplam 24 hasta ve 25 total mastektomi uygulanmış memeye geç dönemde latissimus dorsi kas-deri flebi + implant ile rekonstrüksiyon uygulandı. Tüm kadın hastaların yaş ortalaması 44.0 olarak hesaplandı. 12 sağ meme ve 13 sol memeye rekonstrüksiyon uygulandı. Ameliyat süresi 135 ile 220 dakika arasında not edildi. Post-operatif olarak hiçbir hastada kısmi ya da total flep nekrozu görülmedi. Enfeksiyon, implant protuzyonu veya rüptürü, hematom veya keloid hiçbir hastada görülmedi. 4 hastada 1 ay kadar süren ve aspirasyon ile düzelen seroma gelişti. 1 hastada 2. ayda meme dokusu üzerinde selülit benzeri bir görünüm mevcuttu. 1 hafta IV antibiyotik tedavisi ile düzelme sağlandı. Donör alanda sadece 3 hastada tatmin edici olmayan skar ile karşılaşıldı. Hiçbir hastada meme alanında kötü skar görülmedi. Rekonstrükte edilen memeler için ortalama 255 (175-300) cc yuvarlak silikon jel implant kullanıldı. TARTIŞMA ve SONUÇ: Latissimus dorsi kas-deri flebi geç dönem meme rekonstrüksiyonu için son derece güvenli ve muteber bir seçenektir. Özellikle ameliyat sonrası komplikasyonlardan çekinen ve en kısa sürede normal hayatına dönmek isteyen hastalar için diğer rekonstrüktif yöntemlere göre basit ve komplikasyonları az bir yöntemdir.

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“…While the argument persists regarding the optimal autologous donor site, [39][40][41] the fact remains that not all patients are candidates for abdominally based autologous breast reconstruction. Our group recently published a review discussing options for sensate reconstruction including flaps that had been utilized as sensate for other recipient sites, and flaps that had yet to be described as sensate.…”

Section: Additional Donor S Ite Smentioning

confidence: 99%

Collaboration between the breast and plastic surgeon in restoring sensation after mastectomy

2019

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Breast cancer is the most commonly diagnosed invasive cancer in women worldwide. While hypoesthesia is a known sequela after mastectomy, patients are now inquiring with renewed interest about the degree and timing of sensation after mastectomy. This is a topic that has generated much research interest. However, while there have been advances in the field, there are few, well‐done studies that allow for an accurate answer to this question. In this article, relevant breast and donor site anatomy is reviewed for sensate autologous breast reconstruction. Additional donor sites apart from the typically utilized abdomen are analyzed with relevant anatomical discussions. Outcomes are presented; however, due to the heterogeneity of the patient population, surgical approach and postoperative sensory testing, it is difficult to compare results between studies. Future directions and unanswered questions regarding sensate autologous breast reconstruction are highlighted. While great strides have been made in providing sensate autologous breast reconstruction, there are still many unanswered questions. Thus, the collaboration between surgical teams and sharing of outcomes is crucial to allow for optimization of this powerful surgical approach.

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Indications and Controversies for Abdominally-Based Complete Autologous Tissue Breast Reconstruction

Cited by 23 publications

References 62 publications

Basic Principles in Microvascular Anastomosis and Free Tissue Transfer

Basic Principles in Microvascular Anastomosis and Free Tissue Transfer

Delayed Breast Reconstruction with Latissimus Dorsi Myocutaneous Flap and Implant in Patients Undergoing Total Mastectomy

Collaboration between the breast and plastic surgeon in restoring sensation after mastectomy

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