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A Novel Method to Estimate the Weight of the DIEP Flap in Breast Reconstruction: DIEP-W, a Simple Calculation Formula Using Paraumbilical Flap Thickness
- Source :
- Journal of Reconstructive Microsurgery. 32:520-527
- Publication Year :
- 2016
- Publisher :
- Georg Thieme Verlag KG, 2016.
-
Abstract
- Background Preoperative estimation of abdominal flap volume is valuable for breast reconstruction, especially in lean patients. The purpose of this study was to develop a formula to estimate the weight of the deep inferior epigastric artery perforator (DIEP) flap using unidimensional parameters. Methods We retrospectively collected data on 100 consecutive patients who underwent breast reconstruction using the DIEP flap. Multiple linear regression analysis was used to develop a formula to estimate the weight of the flap. Predictor variables included body mass index, height of the flap, width of the flap, and flap thickness on computed tomography angiographic images at three paraumbilical sites: 5 cm right, left, and inferior from the umbilicus. Then we prospectively tested the accuracy of the developed formula in 38 consecutive patients who underwent breast reconstruction with free DIEP flaps. Results A calculation formula and a smartphone application, DIEP-W was developed from retrospective analysis (R (2) = 92.7%, p 0.001). In the prospective study, the average estimated weight was 96.3% of the actual weight, giving the formula a mean absolute percentage error of 7.7% (average differences of 45 g). The flap size in the prospective group was significantly smaller (p 0.001) and donor-site complications were less (p = 0.002) than those of retrospective group. Conclusion Surgeons can easily calculate the DIEP weight with varying flap dimensions in a real-time fashion using this formula during preoperative planning and intraoperative design. Estimating the flap weight facilitates economical use of the flap, which can lead to reduced donor-site complications.
- Subjects :
- Adult
medicine.medical_specialty
Mammaplasty
Umbilicus (mollusc)
030230 surgery
Preoperative care
Body Mass Index
03 medical and health sciences
0302 clinical medicine
Fiducial Markers
DIEP flap
Preoperative Care
medicine
Humans
Retrospective Studies
Preoperative planning
medicine.diagnostic_test
business.industry
Deep Inferior Epigastric Artery
Angiography
Reproducibility of Results
Organ Size
Middle Aged
Epigastric Arteries
Mobile Applications
eye diseases
Surgery
030220 oncology & carcinogenesis
Female
Multiple linear regression analysis
Smartphone
Breast reconstruction
business
Perforator Flap
Subjects
Details
- ISSN :
- 10988947 and 0743684X
- Volume :
- 32
- Database :
- OpenAIRE
- Journal :
- Journal of Reconstructive Microsurgery
- Accession number :
- edsair.doi.dedup.....7456a1b92466675d7709853d775423ad