Pre-operative predictive estimation of abdominal flap volume for breast reconstruction using ultrasound and an anthropometric method

Taha, Ahmed; Noman, Ayman El; Mahboub, Tarek; Zaki, Amr A; El-Rahman, Rasha W. Abd; Essawy, M. El; Ismail, A.

doi:10.1007/s00238-018-1412-5

Cited by 1 publication

(2 citation statements)

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“…For instance, ultrasonography has been utilized to estimate abdominal flap volume, a method that requires up to 30 minutes to complete. 5,7,9 Although ultrasonography has been described for preoperative perforator mapping, it is less commonly used than CTA and thus may not be a routine component of preoperative planning at most institutions. 13 Another method described by Woo et al, dubbed the "pinch test," is comprised of three paraumbilical abdominal thickness measurements obtained using a skin- fold caliper, in addition to flap height, flap width, and patient BMI.…”

Section: Discussionmentioning

confidence: 99%

“…2 Several flap weight and volume estimation methods have been previously described. [2][3][4][5][6][7][8][9][10][11] Although precise, these methods require a multitude of anthropomorphic measurements obtained using either caliper-based subcutaneous thickness, computed tomography angiography (CTA), magnetic resonance imaging, or three-dimensional photography. Given the necessity of utilizing multiple measurements to obtain an estimate, these methods are often time consuming and may be rendered cumbersome to perform.…”

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confidence: 99%

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Estimation of Hemi-Abdominal-Based Free Flap Weight Using Two Computed Tomography-Derived Measurements

Greige

Liu

Nash

et al. 2021

J Reconstr Microsurg

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Background Accurate flap weight estimation is crucial for preoperative planning in microsurgical breast reconstruction; however, current flap weight estimation methods are time consuming. It was our objective to develop a parsimonious and accurate formula for the estimation of abdominal-based free flap weight. Methods Patients who underwent hemi-abdominal-based free tissue transfer for breast reconstruction at a single institution were retrospectively reviewed. Subcutaneous tissue thicknesses were measured on axial computed tomography angiograms at several predetermined points. Multivariable linear regression was used to generate the parsimonious flap weight estimation model. Split-sample validation was used to for internal validation. Results A total of 132 patients (196 flaps) were analyzed, with a mean body mass index of 31.2 ± 4.0 kg/m2 (range: 22.6–40.7). The mean intraoperative flap weight was 990 ± 344 g (range: 368–2,808). The full predictive model (R 2 = 0.68) estimated flap weight using the Eq. 91.3x + 36.4y + 6.2z – 1030.0, where x is subcutaneous tissue thickness (cm) 5 cm lateral to midline at the level of the anterior superior iliac spine (ASIS), y is distance (cm) between the skin overlying each ASIS, and z is patient weight (kg). Two-thirds split-sample validation was performed using 131 flaps to build a model and the remaining 65 flaps for validation. Upon validation, we observed a median percent error of 10.2% (interquartile range [IQR]: 4.5–18.5) and a median absolute error of 108.6 g (IQR: 45.9–170.7). Conclusion We developed and internally validated a simple and accurate formula for the preoperative estimation of hemi-abdominal-based free flap weight for breast reconstruction.

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