Document Detail


Rib-sparing and internal mammary artery-preserving microsurgical breast reconstruction with the free DIEP flap.
MedLine Citation:
PMID:  23446581     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Using an internal mammary artery as the recipient vessel in a free flap autologous breast reconstruction is common practice, but this vessel is often sacrificed for end-to-end anastomosis and is typically assessed by removing a costal cartilage segment. The authors studied the reliability of the end-to-side arterial anastomosis using a rib-sparing approach by comparing it with end-to-end anastomosis.
METHODS: The authors analyzed 100 consecutive medical records of patients who underwent autologous breast reconstruction with a free deep inferior epigastric artery perforator flap in which the internal mammary vessels were assessed using a rib-sparing technique. The study compared the complications between the two groups of end-to-side arterial anastomosis (50 cases) and end-to-end arterial anastomosis (50 cases).
RESULTS: Exposure of the internal mammary artery using a rib-sparing technique was performed successfully in all 100 flaps. The second and third intercostal spaces were used in 46 and 54 cases, respectively. The mean width of the used intercostal space was 18.3 ± 2.4 mm in the end-to-side group and 18.3 ± 2.9 mm in the end-to-end group (p = 0.923). All flaps survived without partial or total necrosis. One case of venous insufficiency that required exploration occurred in the end-to-side group; the flap was totally saved with venous revision. There was no significant statistical difference between the end-to-side and end-to-end groups in all other variables, including mean flap ischemic time (p = 0.431) and fat necrosis (p = 0.339).
CONCLUSION: The rib-sparing and internal mammary artery-preserving free deep inferior epigastric artery perforator flap transfer is an efficient and safe technique for microsurgical breast reconstruction.
Authors:
Hyungsuk Kim; So-Young Lim; Jai-Kyong Pyon; Sa-Ik Bang; Kap Sung Oh; Jeong Eon Lee; Seok Jin Nam; Goo-Hyun Mun
Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Plastic and reconstructive surgery     Volume:  131     ISSN:  1529-4242     ISO Abbreviation:  Plast. Reconstr. Surg.     Publication Date:  2013 Mar 
Date Detail:
Created Date:  2013-02-28     Completed Date:  2013-04-22     Revised Date:  2014-10-13    
Medline Journal Info:
Nlm Unique ID:  1306050     Medline TA:  Plast Reconstr Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  327e-34e     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Adult
Anastomosis, Surgical / methods
Female
Free Tissue Flaps*
Humans
Mammaplasty / methods*
Mammary Arteries / surgery*
Microsurgery*
Middle Aged
Perforator Flap*
Retrospective Studies
Ribs
Comments/Corrections
Comment In:
Plast Reconstr Surg. 2013 Nov;132(5):870e-871e   [PMID:  24165646 ]
Plast Reconstr Surg. 2013 Nov;132(5):868e-870e   [PMID:  24165645 ]

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


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