Technique and outcomes of laparoscopic bulge repair after abdominal free flap reconstruction

Lee, Johnson C.; Whipple, Lauren A.; Binetti, Brian; Singh, Tejinder P.; Agag, Richard L.

doi:10.1002/micr.30026

Cited by 3 publications

(1 citation statement)

References 22 publications

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“…No individual study within this review demonstrated increased risk of abdominal wall morbidity including hernia, bulge, or abdominal wall laxity following free tissue transfer in this cohort (►Table 4). 4,7,15,31,34,36,42,43,45,51 However, in a subgroup analysis, Wes et al found that while patients with prior hernia repair were more likely to develop a bulge following abdominal free tissue transfer, this was not true for their overall abdominal scar cohort. 15 Similarly, Roostaeian et al demonstrated that patients with no prior history of abdominal surgery who underwent MS-0 or MS-1 free flap reconstructions were at higher risk of postoperative bulge compared with patients with prior abdominal surgery, however, this difference did not remain for MS-2 and MS-3 reconstruction types.…”

Section: Postoperative Abdominal Wall Morbiditymentioning

confidence: 99%

The Impact of Prior Abdominal Surgery on Complications of Abdominally Based Autologous Breast Reconstruction: A Systematic Review and Meta-Analysis

Bond

Soteropulos

Yang

et al. 2021

J Reconstr Microsurg

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Background Approximately half of all patients presenting for autologous breast reconstruction have abdominal scars from prior surgery, the presence of which is considered by some a relative contraindication for abdominally based reconstruction. This meta-analysis examines the impact of prior abdominal surgery on the complication profile of breast reconstruction with abdominally based free tissue transfer. Methods Literature search was conducted using PubMed, Scopus, and Web of Science. Included studies examined patients with a history of prior abdominal surgery who then underwent abdominally based free flap breast reconstruction. Prior liposuction patients and those with atypical flap designs were excluded. The Newcastle-Ottawa Scale was used to assess study quality. Flap complications included total and partial flap loss, fat necrosis, infection, and reoperation. Donor-site complications included delayed wound healing, infection, seroma, hematoma, and abdominal wall morbidity (hernia, bulge, laxity). Relative risk and 95% confidence intervals (CIs) between groups were calculated. Forest plots, I 2 statistic heterogeneity assessments, and publication bias funnel plots were produced. Publication bias was corrected with a trim-and-fill protocol. Overall effects were assessed by fixed-effects and random-effects models. Results After inclusion and exclusion criteria were applied, 16 articles were included for final review. These included 14 cohort and 2 case–control studies, with 1,656 (46.3%) patients and 2,236 (48.5%) flaps having undergone prior surgery. Meta-analysis showed patients with prior abdominal surgery were significantly more likely to experience donor-site delayed wound healing with a risk ratio of 1.27 (random 95% CI [1.00; 1.61]; I 2= 4) after adjustment for publication bias. No other complications were statistically different between groups. Conclusion In patients with a history of prior abdominal surgery, abdominally based free tissue transfer is a safe and reliable option. Abdominal scars may slightly increase the risk of delayed donor-site wound healing, which can aid the surgeon in preoperative counseling.

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Section: Postoperative Abdominal Wall Morbiditymentioning

confidence: 99%

The Impact of Prior Abdominal Surgery on Complications of Abdominally Based Autologous Breast Reconstruction: A Systematic Review and Meta-Analysis

Bond

Soteropulos

Yang

et al. 2021

J Reconstr Microsurg

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Outcomes of posterior component separation with transversus abdominis release for repair of abdominally based breast reconstruction donor site hernias

McLaughlin,

Montelione,

et al. 2024

Hernia

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Using Mesh to Reinforce the Abdominal Wall in Abdominal Free Flaps for Breast Reconstruction

Leon

Nazerali

Lee

2018

Annals of Plastic Surgery

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In our current treatment algorithm, patients who received mesh were selected based upon several criteria, including obesity, weak fascia identified during surgery, and extensive muscle dissection. We confirm that the risk of bulging and herniation is decreased in patients receiving mesh. Furthermore, the risk of wound infection was not associated with the use of mesh; instead, a patient's elevated body mass index, as well as tension of closure, and other comorbidities are more likely causes of superficial wound complications. We find the use of mesh to be safe and beneficial in select patients undergoing abdominal free flap breast reconstruction who are at risk for hernias and bulges.

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Technique and outcomes of laparoscopic bulge repair after abdominal free flap reconstruction

Cited by 3 publications

References 22 publications

The Impact of Prior Abdominal Surgery on Complications of Abdominally Based Autologous Breast Reconstruction: A Systematic Review and Meta-Analysis

The Impact of Prior Abdominal Surgery on Complications of Abdominally Based Autologous Breast Reconstruction: A Systematic Review and Meta-Analysis

Outcomes of posterior component separation with transversus abdominis release for repair of abdominally based breast reconstruction donor site hernias

Using Mesh to Reinforce the Abdominal Wall in Abdominal Free Flaps for Breast Reconstruction

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