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A Comparative Analysis of Risk Factors for Breast Skin Necrosis following Autologous versus Device-Based Breast Reconstruction.
- Source :
-
Journal of reconstructive microsurgery [J Reconstr Microsurg] 2023 May; Vol. 39 (4), pp. 288-294. Date of Electronic Publication: 2022 Jun 29. - Publication Year :
- 2023
-
Abstract
- Background: Mastectomy skin flap necrosis often necessitates prolonged wound care, surgical re-excision, and it increases the risk for infection. This study aims to compare rates of skin flap necrosis between autologous and device-based reconstructions and identify risk factors.<br />Methods: The authors retrospectively identified patients who underwent immediate breast reconstruction using either the deep inferior epigastric perforator (DIEP) flap ( n = 373 breasts, 41%) or tissue expanders ( n = 529 breasts, 59%) by two surgeons at a single institution between 2011 and 2021. The rate of skin flap necrosis between autologous and device-based reconstructions was compared and multivariate regression analysis was performed to identify risk factors.<br />Results: There was no significant difference in rates of skin flap necrosis between the two cohorts (26.8 vs. 15.5%, p = 0.052). Across all patients, hypertension and body mass index >30 were significant predictors of necrosis ( p = 0.024 and p <0.001, respectively). Within our DIEP cohort, mastectomy specimen weight was a significant risk factor for necrosis ( p = 0.001). The DIEP flap weight itself did not confer a higher risk for necrosis ( p = 0.8).<br />Conclusion: Immediate autologous reconstruction does not place patients at higher risk of skin necrosis. Hypertension and obesity (body mass index >30) were independent risk factors for necrosis in all patients. Mastectomy specimen weight was a significant predictor of necrosis in DIEP flap patients while the DIEP flap weight itself did not increase the risk for necrosis.<br />Competing Interests: None declared.<br /> (Thieme. All rights reserved.)
- Subjects :
- Humans
Female
Mastectomy adverse effects
Retrospective Studies
Risk Factors
Postoperative Complications surgery
Necrosis etiology
Epigastric Arteries surgery
Breast Neoplasms surgery
Perforator Flap adverse effects
Perforator Flap surgery
Mammaplasty adverse effects
Hypertension complications
Hypertension surgery
Subjects
Details
- Language :
- English
- ISSN :
- 1098-8947
- Volume :
- 39
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- Journal of reconstructive microsurgery
- Publication Type :
- Academic Journal
- Accession number :
- 35768010
- Full Text :
- https://doi.org/10.1055/a-1887-7645