Anouk J M Cornelissen1, Jop Beugels1, Arno Lataster2, Esther M Heuts3, Shai M Rozen4, Aldona J Spiegel5, René R W J van der Hulst1, Stefania M H Tuinder6. 1. Department of Plastic and Reconstructive Surgery, Maastricht University Medical Center +, P. Debyelaan 25, 6229 HX Maastricht, The Netherlands. 2. Department of Anatomy and Embryology, Maastricht University, Universiteitssingel 50, 6229 ER Maastricht. The Netherlands. 3. Department of Surgery, Maastricht University Medical Center +, P. Debyelaan 25, 6229 HX Maastricht. The Netherlands. 4. Department of Plastic and Reconstructive Surgery, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX 75390, USA. 5. Division of Plastic Surgery, Houston Methodist Hospital, 6565 Fannin St, Houston, TX 77030, USA. 6. Department of Plastic and Reconstructive Surgery, Maastricht University Medical Center +, P. Debyelaan 25, 6229 HX Maastricht, The Netherlands. Electronic address: s.tuinder@mumc.nl.
Abstract
INTRODUCTION: Autologous breast reconstruction has become the standard care for breast cancer patients. Although excellent cosmetic results can be achieved, most reconstructed breasts fail to regain normal sensation. Nerve coaptation of the flap has been suggested to improve sensation; the effect of the donor flap native sensory threshold on the degree of sensory restoration is yet to be determined. The aim of this study is to evaluate the differences in sensation between various potential donor site regions in comparison to the sensation of the healthy breast. PATIENTS AND METHODS: A cross-sectional study in healthy women was performed in the Maastricht University Medical Centre. Monofilaments were used to measure sensation in the breast and at different flap donor sites: deep inferior epigastric perforator (DIEP), lateral thigh perforator (LTP), profunda artery perforator (PAP), superior gluteal artery perforator (SGAP) and transverse musculocutaneous gracilis (TMG) flaps. The Wilcoxon signed rank test was used to analyse statistical significance in sensation. RESULTS: Fifty women with a mean age of 49 ± 2.72 years and mean BMI of 26.14 ± 0.89 kg/m2 were included in the study. The median monofilament value of the normal breasts was 2.97(2.56-3.55). The median monofilament value of each donor site and p value when compared to the healthy breast were as follows: DIEP flap, 2.62 (2.36-3.22) p < 0.01; LTP flap, 3.61 (2.83-4.08) p <0.01; PAP flap, 3.09 (2.67-3.5) p = 0.97; SGAP flap, 3.22 (2.64-3.87) p = 0.01; and TMG flap, 3.03 (2.6-3.47) p = 0.69. CONCLUSIONS: There is a significant difference in sensation between the various donor site regions for breast reconstruction and the healthy breast. This may be taken into consideration for donor site selection.
INTRODUCTION: Autologous breast reconstruction has become the standard care for breast cancerpatients. Although excellent cosmetic results can be achieved, most reconstructed breasts fail to regain normal sensation. Nerve coaptation of the flap has been suggested to improve sensation; the effect of the donor flap native sensory threshold on the degree of sensory restoration is yet to be determined. The aim of this study is to evaluate the differences in sensation between various potential donor site regions in comparison to the sensation of the healthy breast. PATIENTS AND METHODS: A cross-sectional study in healthy women was performed in the Maastricht University Medical Centre. Monofilaments were used to measure sensation in the breast and at different flap donor sites: deep inferior epigastric perforator (DIEP), lateral thigh perforator (LTP), profunda artery perforator (PAP), superior gluteal artery perforator (SGAP) and transverse musculocutaneous gracilis (TMG) flaps. The Wilcoxon signed rank test was used to analyse statistical significance in sensation. RESULTS: Fifty women with a mean age of 49 ± 2.72 years and mean BMI of 26.14 ± 0.89 kg/m2 were included in the study. The median monofilament value of the normal breasts was 2.97(2.56-3.55). The median monofilament value of each donor site and p value when compared to the healthy breast were as follows: DIEP flap, 2.62 (2.36-3.22) p < 0.01; LTP flap, 3.61 (2.83-4.08) p <0.01; PAP flap, 3.09 (2.67-3.5) p = 0.97; SGAP flap, 3.22 (2.64-3.87) p = 0.01; and TMG flap, 3.03 (2.6-3.47) p = 0.69. CONCLUSIONS: There is a significant difference in sensation between the various donor site regions for breast reconstruction and the healthy breast. This may be taken into consideration for donor site selection.
Authors: Anouk J M Cornelissen; Stefania M H Tuinder; Esther M Heuts; René R W J van der Hulst; Jenny Slatman Journal: BMC Womens Health Date: 2018-06-01 Impact factor: 2.809