BACKGROUND: Breast cancer is the commonest form of cancer in women affecting almost a quarter of a million patients in the US annually. 30 percent of these patients and patients with genetic mutations undergo removal of the breast, as highlighted in a high profile celebrity patient. Although breast reconstruction with free microvascular transfer of a DIEAP flap from the abdomen is an ideal form of reconstruction, there have been misgivings about the complexity and potential complications. This study was aimed at clearing these misunderstandings and establishing the value of this form of breast reconstruction. METHODS: 1036 DIEAP flap breast reconstructions carried out at the University Hospital, Gent (five year period) and at the Sana Kliniken, Düsseldorf (three year period) were included prospectively. Comorbid factors like chemotherapy, radiotherapy, patient age >65 years, BMI >30 and smoking were recorded. Outcomes were evaluated over a mean follow up of 2 years. RESULTS: Overall complication rate related to the reconstructed breast and donor abdominal area was 6.8 percent. Total flap loss was seen in only 0.8 percent. The mean operating time was less than five hours. Older age, higher BMI, chemotherapy and radiotherapy did not have a significant influence on complication rates, however smoking resulted in significant delay in wound healing in the breast (p = 0.025) and abdominal wounds (p = 0.019). CONCLUSION: The DIEAP flap is an excellent option for breast reconstruction, with a low level of donor site morbidity and complications. It is an autologous reconstruction that provides a stable long term result.
BACKGROUND:Breast cancer is the commonest form of cancer in women affecting almost a quarter of a million patients in the US annually. 30 percent of these patients and patients with genetic mutations undergo removal of the breast, as highlighted in a high profile celebrity patient. Although breast reconstruction with free microvascular transfer of a DIEAP flap from the abdomen is an ideal form of reconstruction, there have been misgivings about the complexity and potential complications. This study was aimed at clearing these misunderstandings and establishing the value of this form of breast reconstruction. METHODS: 1036 DIEAP flap breast reconstructions carried out at the University Hospital, Gent (five year period) and at the Sana Kliniken, Düsseldorf (three year period) were included prospectively. Comorbid factors like chemotherapy, radiotherapy, patient age >65 years, BMI >30 and smoking were recorded. Outcomes were evaluated over a mean follow up of 2 years. RESULTS: Overall complication rate related to the reconstructed breast and donor abdominal area was 6.8 percent. Total flap loss was seen in only 0.8 percent. The mean operating time was less than five hours. Older age, higher BMI, chemotherapy and radiotherapy did not have a significant influence on complication rates, however smoking resulted in significant delay in wound healing in the breast (p = 0.025) and abdominal wounds (p = 0.019). CONCLUSION: The DIEAP flap is an excellent option for breast reconstruction, with a low level of donor site morbidity and complications. It is an autologous reconstruction that provides a stable long term result.
Authors: K F Schrögendorfer; S Nickl; M Keck; D B Lumenta; C Loewe; M Gschwandtner; W Haslik; J Nedomansky Journal: Eur Surg Date: 2016-10-19 Impact factor: 0.953
Authors: Dmytro Unukovych; Camilo Hernandez Gallego; Helena Aineskog; Andres Rodriguez-Lorenzo; Maria Mani Journal: Plast Reconstr Surg Glob Open Date: 2016-08-29
Authors: Carlos Mavioso; Ricardo J Araújo; Hélder P Oliveira; João C Anacleto; Maria Antónia Vasconcelos; David Pinto; Pedro F Gouveia; Celeste Alves; Fátima Cardoso; Jaime S Cardoso; Maria João Cardoso Journal: Breast Date: 2020-01-12 Impact factor: 4.380
Authors: Laura C Siegwart; Sebastian Fischer; Yannick F Diehm; Jörg M Heil; Christoph Hirche; Ulrich Kneser; Dimitra Kotsougiani-Fischer Journal: Breast Cancer Date: 2021-06-06 Impact factor: 4.239