The Use Of The Diep Flap In The Modern Reconstructive Surgery

Ulatowski, Łukasz; Kaniewska, A

doi:10.1515/pjs-2015-0091

Cited by 7 publications

(4 citation statements)

References 55 publications

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“…The current tissue reconstruction strategies such as breast implants, lipofilling, and microsurgical-free tissue transplantation are the most often applied procedures for repairing soft tissue defects due to surgical resections such as mastectomy/lumpectomy, following breast cancer. However, there are numerous drawbacks associated with the current approaches, such as seroma (a localized accumulation of serous fluid), infection, the need for reintervention, flap necrosis, and fat resorption. − As a result, new techniques, such as adipose tissue engineering (TE), need to be explored to ensure a successful reconstruction. The clinical need for tissue engineering is justified by several epidemiological studies highlighting the current clinical drawbacks .…”

Section: Introductionmentioning

confidence: 99%

Toward Adipose Tissue Engineering Using Thiol-Norbornene Photo-Crosslinkable Gelatin Hydrogels

et al. 2021

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Nowadays, breast implants, lipofilling, and microsurgical free tissue transfer are the most often applied procedures to repair soft tissue defects resulting from mastectomies/lumpectomies following breast cancer. Due to the drawbacks and limitations associated with these conventional clinical practices, there is a need for alternative reconstructive strategies. The development of biomimetic materials able to promote cell proliferation and adipogenic differentiation has gained increasing attention in the context of adipose reconstructive purposes. Herein, thiol-norbornene crosslinkable gelatin-based materials were developed and benchmarked to the current commonly applied methacryloyl-modified gelatin (GelMA) with different degrees of substitutions focussing on bottom-up tissue engineering. The developed hydrogels resulted in similar gel fractions, swelling, and in vitro biodegradation properties compared to the benchmark materials. Furthermore, the thiol-ene hydrogels exhibited mechanical properties closer to those of native fatty tissue compared to GelMA. The mechanical cues of the equimolar GelNB DS55% + GelSH DS75% composition resulted not only in similar biocompatibility but also, more importantly, in superior differentiation of the encapsulated cells into the adipogenic lineage, as compared to GelMA. It can be concluded that the photo-crosslinkable thiol-ene systems offer a promising strategy toward adipose tissue engineering through cell encapsulation compared to the benchmark GelMA.

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Section: Introductionmentioning

confidence: 99%

Toward Adipose Tissue Engineering Using Thiol-Norbornene Photo-Crosslinkable Gelatin Hydrogels

et al. 2021

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“…In Poland approximately 50 free TRAM, DIEP and SIEA breast reconstructions are performed annually, and probably double that number in 2017 [15]. In contrast, in Germany, the annual number of free flaps for breast reconstruction is about 1200, including 200 in Duesseldorf, where reimbursement is more generous (unilateral DIEP -14,200 euro, bilateral DIEP-18,500 euro, free TRAM-9800 euro and pedicled TRAM-7500 euro) (Andree, personal communication).…”

Section: Authors' Contributionmentioning

confidence: 99%

Landscape of oncoplastic breast surgery across Poland

et al. 2017

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Oncoplastic and reconstructive techniques are essential tools in the armamentarium of contemporary breast surgeons. The aim of the study was to identify oncoplastic reconstructive patterns in breast cancer centers across Poland. A questionnaire of 18 questions was sent by email to the members of the Polish Society of Surgical Oncology and the Polish Society of Plastic, Reconstructive and Esthetic Surgery via their dedicated websites. The numbers of breast cancer patients operated on in each center ranged from 120 to 904 per year. Breast-conserving surgery (BCS) predominated in all but one center (range 50-70%). Immediate breast reconstructions (IBR) accounted for 6-42% of procedures, The most frequent type of IBR was either a two-stage expander followed by a permanent implant or one-stage implant- based with or without synthetic mesh. The most frequent type of delayed breast reconstruction (DBR) was a two-stage expander followed by implant-based reconstruction. None of the surveyed cancer centers performed free flap reconstruction. Deep inferior epigastric perforator (DIEP) flaps were performed in the plastic surgery department. Reconstructions based on pedicled flaps were performed in cancer centers. Acellular dermal matrices (ADM) and fat transfer were used in selected centers. In the clinical scenario of adjuvant radiotherapy, delayed breast reconstruction was favored. The full range of oncoplastic BCS was performed. Patient-reported outcome measures (PROM) and complications were assessed. Our findings can act as a platform for further improvement in skills, certification, data collection and audit, including patient reported expectation measures. There is also an urgent need to address pan-European inconsistencies in procedural reimbursement.

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“…Their first immediate face transplant and refinements of head and neck cancer reconstructions have had a high profile in recent years. Roughly speaking, in Poland 42 free TRAM, DIEP and SIEA breast reconstructions are performed annually [51] (also personal communication with Ulatowski -Medical Center for Postgraduate Education in Warsaw and Ulczok -Insitute of Oncology in Gliwice). Hopefully, these numbers will double in 2017.…”

Section: Polish Perspectivementioning

confidence: 99%

Flap-based breast reconstructions

Bartlett

Kołacińska

Spiegel

2017

Nowotwory. Journal of Oncology

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Breast cancer reconstruction is generally broken down into two major categories: Implant based and autologous. Both can provide excellent aesthetic results in the well selected patient although the decision ultimately comes down to the patient under the guidance of a reconstructive plastic surgeon. Implant based reconstruction is beyond the scope of this text, rather we will discuss autologous based reconstructive options. Broadly classified, tissue based reconstruction can be categorized as local or free tissue transfer. The general theme is the use of excess or expendable tissue in order to reconstruct breast defects. Studies have shown women are more satisfied with autologous based reconstruction compared to implanted based [1]. In this chapter we will discuss different tissue flap options in the reconstructive plastic surgeons armamentarium, special considerations and how it relates to the oncologic breast surgeon.

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The Use Of The Diep Flap In The Modern Reconstructive Surgery

Cited by 7 publications

References 55 publications

Toward Adipose Tissue Engineering Using Thiol-Norbornene Photo-Crosslinkable Gelatin Hydrogels

Toward Adipose Tissue Engineering Using Thiol-Norbornene Photo-Crosslinkable Gelatin Hydrogels

Landscape of oncoplastic breast surgery across Poland

Flap-based breast reconstructions

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