Trends and Innovations in Autologous Breast Reconstruction

Speck, Nicole E.; Grufman, Vendela; Farhadi, Jian

doi:10.1055/s-0043-1767788

Cited by 5 publications

(4 citation statements)

References 64 publications

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“…Thus, instead of approximate measurement, the surgeon would be able to see the individual perforator anatomy directly on the abdominal wall of the patient. For optimizing intraoperative procedure, robotic technology aims to increase surgical precision, therefore minimizing complications [67][68][69]. The clinical significance of these innovations must be demonstrated in the following years.…”

Section: Discussionmentioning

confidence: 99%

The Impact of Technical Innovations and Donor-Site Mesh Repair on Autologous Abdominal-Based Breast Reconstruction—A Retrospective Analysis

Promny,

Huberth,

Müller-Seubert

et al. 2024

JCM

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Background: The aim of this study was to examine the potential benefit that may be achieved through the introduction of technical innovations and the incorporation of mesh for fascial donor site closure in uni- and bilateral autologous breast reconstruction with abdominal tissue. Methods: A retrospective single-center review of all breast reconstructions with a DIEP or MS-TRAM flap between January 2004 and December 2019 was performed. Donor and recipient site complications and operation times were evaluated before and after the implementation of coupler anastomoses, preoperative computed tomography angiography (CTA), indocyanine green (ICG) angiography, and the inclusion of mesh in donor site repair. Results: A total of 396 patients were included, accounting for 447 flaps. Operation time was significantly shorter in unilateral reconstructions after the implementation of CTA (p < 0.0001). ICG angiography significantly reduced the rates of partial flap loss (p = 0.02) and wound healing disorders (p = 0.02). For unilateral reconstructions, abdominal bulging or hernia was observed more often in MS1-TRAM flaps without synthetic mesh repair (p = 0.001), whereas conservatively treated seroma developed more frequently after mesh implantation (p = 0.03). Conclusions: Recent technological advancements developed over the past few decades have made a substantial impact on decreasing surgical duration and enhancing procedure safety.

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Section: Discussionmentioning

confidence: 99%

The Impact of Technical Innovations and Donor-Site Mesh Repair on Autologous Abdominal-Based Breast Reconstruction—A Retrospective Analysis

Promny,

Huberth,

Müller-Seubert

et al. 2024

JCM

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“…These findings were corroborated in a large Spanish multicenter analysis of 1,450 pre-pectoral breast reconstructions with ADM, reporting a low incidence of capsular contracture (2.1%) [110] . Postoperative wound care with hydrogel and hydrocolloid dressings have also been used, citing the benefits of moist environments to prevent pain and accelerate wound healing [111,112] .…”

Section: Future Directionsmentioning

confidence: 99%

The radiated breast and autologous reconstruction: benefits and alternatives

Ewing,

Gala,

Lemdani

et al. 2024

Plast Aesthet Res

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Despite advancements in research and technology, breast cancer remains the second leading cause of cancer-related mortality affecting women worldwide. Radiation therapy is a widely recommended adjunct to surgery due to its significant role in reducing loco-regional recurrence. Its use, however, is not without consequences. Radiation triggers a series of pathophysiologic events leading to tissue injury; reactive oxygen species incites (1) vascular damage and chronic hypoxia; (2) an inflammatory response; and (3) activation of myofibroblasts to induce fibrosis. As a result, radiotherapy interferes with wound healing and negatively impacts the quality of the skin. These pathophysiologic consequences complicate the sequence of breast reconstruction and require surgeons to consider timing and the type of reconstruction (autologous vs. implant), with respect to radiotherapy to improve patient outcomes. In this article, we briefly review radiation-induced tissue effects and their impact on breast reconstruction. More specifically, we comment on the traditional use of autologous tissue, microsurgical technical pearls for irradiated fields, reconstructive timing paradigms, and lymphedema prevention. With continued progress, derivation, and innovation, plastic and reconstructive surgery has consistently advanced and revolutionized both medicine and surgery. This review considers the future implications of breast reconstruction and how it will impact patients, healthcare, and the field. While not an exhaustive review, we aim to provide a comprehensive discussion and insights. In summary, the authors discuss the possibilities of a paradigm shift in breast reconstruction, emphasizing the need for surgeons to have an armamentarium capable of all breast reconstruction options for the best possible patient outcomes.

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“…Moreover, multiple surgeries are needed due to the limited lifetime of current silicon implants ( 7 ). In contrast, autologous flaps provide a natural result that can be stable in time and avoid any foreign materials with all linked disadvantages ( 8 ). However, it requires a high degree of technical skills for the flap and pedicle dissection, longer surgeries, and may still need improvement despite recent microsurgery advances.…”

Section: Introductionmentioning

confidence: 99%

Tissue engineering strategies for breast reconstruction: a literature review of current advances and future directions

Berkane,

Oubari,

van Dieren

et al. 2024

Ann Transl Med

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Background and Objective Mastectomy is a primary treatment for breast cancer patients, and both autologous and implant-based reconstructive techniques have shown excellent results. In recent years, advancements in bioengineering have led to a proliferation of innovative approaches to breast reconstruction. This article comprehensively explores the promising perspectives offered by bioengineering and tissue engineering in the field of breast reconstruction. Methods A literature review was conducted between April and June 2023 on PubMed and Google Scholar Databases. All English and French articles related to bioengineering applied to the field of breast reconstruction were included. We used the Evidence-Based Veterinary Medicine Association (EBVM) Toolkit 14 checklist for narrative reviews as a quality assurance measure and the Scale for the Assessment of Narrative Review Articles (SANRA) tool to self-assess our methodology. Key Content and Findings Over 130 references related to breast bioengineering were included. The analysis revealed four key applications: enhancing the quality of the skin envelope, improving the viability of fat grafting, creating breast shape and volume via bio-printing, and optimizing nipple reconstruction through engineering techniques. The primary identified approaches revolved around establishing structural support and enhancing cellular viability. Structural techniques predominantly involved the implementation of 3D printed, decellularized, or biocompatible material scaffolds. Meanwhile, promoting cellular content trophicity primarily focused on harnessing the regenerative potential of adipose-derived stem cells (ADSCs) and increasing the tissue’s survivability and cell trophicity. Conclusions Tissue and bioengineering hold immense promise in the field of breast reconstruction, offering a diverse array of approaches. By combining existing techniques with novel advancements, they have the potential to significantly enhance the therapeutic options available to plastic and reconstructive surgeons.

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Trends and Innovations in Autologous Breast Reconstruction

Cited by 5 publications

References 64 publications

The Impact of Technical Innovations and Donor-Site Mesh Repair on Autologous Abdominal-Based Breast Reconstruction—A Retrospective Analysis

The Impact of Technical Innovations and Donor-Site Mesh Repair on Autologous Abdominal-Based Breast Reconstruction—A Retrospective Analysis

The radiated breast and autologous reconstruction: benefits and alternatives

Tissue engineering strategies for breast reconstruction: a literature review of current advances and future directions

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