Document Detail


Optimal timing of delayed free lower abdominal flap breast reconstruction after postmastectomy radiation therapy.
MedLine Citation:
PMID:  21364413     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The purpose of this study was to determine the optimal timing of delayed abdominal free flap breast reconstruction following postmastectomy radiation therapy. The authors evaluated the association between timing of delayed abdominal free flap breast reconstruction following postmastectomy radiation therapy and postoperative complications.
METHODS: The authors reviewed a prospectively maintained database of delayed abdominal free flap breast reconstruction performed between July of 2005 and December of 2009. Data regarding demographics, operative variables, and clinical outcomes were collected. Patients were classified as having undergone reconstruction less than 12 months after postmastectomy radiation therapy (group I) or 12 months or more after postmastectomy radiation therapy (group II). Complications were compared between groups, including microvascular thrombosis, flap loss, reoperation, wound dehiscence, and fat necrosis.
RESULTS: One hundred eighty-nine patients were identified, 82 (43.4 percent) in group I and 107 (56.6 percent) in group II. The total flap loss rate was 2.6 percent, with all flap losses occurring in group I (p = 0.014). The reoperation rate was higher in group I (14.6 percent versus 4.7 percent; p = 0.022). In addition, group I patients trended toward a higher incidence of microvascular thrombosis, infection, and wound dehiscence.
CONCLUSIONS: Patients who underwent delayed abdominal free flap breast reconstruction after 12 months from the completion of postmastectomy radiation therapy developed fewer complications, including microvascular thrombosis and total flap loss, than those who underwent delayed abdominal free flap breast reconstruction within 12 months of completing postmastectomy radiation therapy. Allowing an interval of 12 months between the completion of postmastectomy radiation therapy and delayed abdominal free flap breast reconstruction will likely minimize complications and optimize outcomes in free flap breast reconstruction in patients receiving postmastectomy radiation.
Authors:
Donald P Baumann; Melissa A Crosby; Jesse C Selber; Patrick B Garvey; Justin M Sacks; David M Adelman; Mark T Villa; Lei Feng; Geoffrey L Robb
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Plastic and reconstructive surgery     Volume:  127     ISSN:  1529-4242     ISO Abbreviation:  Plast. Reconstr. Surg.     Publication Date:  2011 Mar 
Date Detail:
Created Date:  2011-03-02     Completed Date:  2011-04-26     Revised Date:  2011-10-24    
Medline Journal Info:
Nlm Unique ID:  1306050     Medline TA:  Plast Reconstr Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1100-6     Citation Subset:  AIM; IM    
Affiliation:
Department of Plastic Surgery, University of Texas M. D. Anderson Cancer Center, Houston, Texas 77030, USA. dpbauman@mdanderson.org
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MeSH Terms
Descriptor/Qualifier:
Abdominal Wall / surgery*
Adult
Aged
Breast Neoplasms / radiotherapy*,  surgery
Female
Follow-Up Studies
Free Tissue Flaps*
Humans
Mammaplasty / methods*
Mastectomy*
Middle Aged
Postoperative Care / methods*
Prospective Studies
Time Factors
Treatment Outcome
Young Adult
Comments/Corrections
Comment In:
Plast Reconstr Surg. 2011 Oct;128(4):373e-374e; author reply 374e-375e   [PMID:  21921754 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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