Unilateral autologous breast reconstruction with unipedicled and bipedicled deep inferior epigastric artery perforator flap: A review of 168 cases over 3years
BackgroundHarvesting a DIEP flap based on bipedicled perforators can enhance vascular perfusion, which can reduce complication rates, minimize fat necrosis, and flap failure. This study summarizes our experience with using unipedicled and bipedicled DIEP flaps for breast reconstruction.Patients and...
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| Veröffentlicht in: | Microsurgery 2020-09, Vol.40 (6), p.663-669 |
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| creator | Yoon Jae Lee Kim, SeongAe Suk‐Ho Moon Young, Joon Jun Rhie, Jong Won Deuk Young Oh |
| description | BackgroundHarvesting a DIEP flap based on bipedicled perforators can enhance vascular perfusion, which can reduce complication rates, minimize fat necrosis, and flap failure. This study summarizes our experience with using unipedicled and bipedicled DIEP flaps for breast reconstruction.Patients and MethodsA total of 168 consecutive patients undergoing unilateral breast reconstruction with DIEP flaps over a 3‐year period were retrospectively reviewed. Primary microvascular anastomoses were performed to the thoracodorsal vessels in both unipedicled and bipedicled DIEP groups. In bipedicled DIEP flap cases, additional secondary microvascular anastomoses were performed either by extraflap or intraflap options. Clinical characteristics and outcomes were recorded.ResultsUnipedicled (n = 89; 53%) and bipedicled flaps were used. Both groups were comparable for mean age, diabetes mellitus, hypertension, smoking, and chemotherapy. BMI was 24.9 ± 3.6 in the unipedicled group and 22.8 ± 2.9 in the bipedicled group (p < .001). The surgical duration was longer in bipedicled group (367 ± 86.5 minu vs 403.7 ± 65.6 min, p |
| doi_str_mv | 10.1002/micr.30601 |
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| fullrecord | <record><control><sourceid>proquest</sourceid><recordid>TN_cdi_proquest_journals_2442943537</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2442943537</sourcerecordid><originalsourceid>FETCH-proquest_journals_24429435373</originalsourceid><addsrcrecordid>eNqNjU1OwzAQhS0EEuVnwwlGYp0yjpMmYYcQqAeAdeU6k-LK2GZst-plOCtZILFl9fT0Pb1PiDuJS4lYP3xaw0uFK5RnYiFx6Ku6a-tzscBO9ZXEvr0UVyntEXEYumEhvt-9dToTawe65ODCLpQEWyadMjCZ4FPmYrINHo42f0DxNtJojaMRtB9h-1dHogjWT8Q2MFC0u_mErQHNs-EEkXgKrPMMJ6fjIzzNhoOlI4QJ5KoHoxMlCAdiUCfSnG7ExaRdotvfvBb3ry9vz-sqcvgqlPJmHwr7GW3qpqmHRrWqU_9b_QC2c2Jb</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2442943537</pqid></control><display><type>article</type><title>Unilateral autologous breast reconstruction with unipedicled and bipedicled deep inferior epigastric artery perforator flap: A review of 168 cases over 3years</title><source>Wiley Online Library - AutoHoldings Journals</source><creator>Yoon Jae Lee ; Kim, SeongAe ; Suk‐Ho Moon ; Young, Joon Jun ; Rhie, Jong Won ; Deuk Young Oh</creator><creatorcontrib>Yoon Jae Lee ; Kim, SeongAe ; Suk‐Ho Moon ; Young, Joon Jun ; Rhie, Jong Won ; Deuk Young Oh</creatorcontrib><description>BackgroundHarvesting a DIEP flap based on bipedicled perforators can enhance vascular perfusion, which can reduce complication rates, minimize fat necrosis, and flap failure. This study summarizes our experience with using unipedicled and bipedicled DIEP flaps for breast reconstruction.Patients and MethodsA total of 168 consecutive patients undergoing unilateral breast reconstruction with DIEP flaps over a 3‐year period were retrospectively reviewed. Primary microvascular anastomoses were performed to the thoracodorsal vessels in both unipedicled and bipedicled DIEP groups. In bipedicled DIEP flap cases, additional secondary microvascular anastomoses were performed either by extraflap or intraflap options. Clinical characteristics and outcomes were recorded.ResultsUnipedicled (n = 89; 53%) and bipedicled flaps were used. Both groups were comparable for mean age, diabetes mellitus, hypertension, smoking, and chemotherapy. BMI was 24.9 ± 3.6 in the unipedicled group and 22.8 ± 2.9 in the bipedicled group (p < .001). The surgical duration was longer in bipedicled group (367 ± 86.5 minu vs 403.7 ± 65.6 min, p < .05) but incidence of fat necrosis decreased in the bipedicle group (24 patients [27%] vs. 7 patients [8.9%] p < .05). There was no flap loss or instance of abdominal hernia in any group.ConclusionsThe bipedicled DIEP flaps may be a feasible option for large breast reconstruction in thin patients. However, the additional microsurgical technical complexity and longer operative time must be considered.</description><identifier>ISSN: 0738-1085</identifier><identifier>EISSN: 1098-2752</identifier><identifier>DOI: 10.1002/micr.30601</identifier><language>eng</language><publisher>Hoboken: Wiley Subscription Services, Inc</publisher><subject>Blood vessels ; Breast ; Chemotherapy ; Diabetes mellitus ; Hernia ; Hypertension ; Mastectomy ; Microvasculature ; Necrosis ; Perfusion</subject><ispartof>Microsurgery, 2020-09, Vol.40 (6), p.663-669</ispartof><rights>2020 Wiley Periodicals LLC.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids></links><search><creatorcontrib>Yoon Jae Lee</creatorcontrib><creatorcontrib>Kim, SeongAe</creatorcontrib><creatorcontrib>Suk‐Ho Moon</creatorcontrib><creatorcontrib>Young, Joon Jun</creatorcontrib><creatorcontrib>Rhie, Jong Won</creatorcontrib><creatorcontrib>Deuk Young Oh</creatorcontrib><title>Unilateral autologous breast reconstruction with unipedicled and bipedicled deep inferior epigastric artery perforator flap: A review of 168 cases over 3years</title><title>Microsurgery</title><description>BackgroundHarvesting a DIEP flap based on bipedicled perforators can enhance vascular perfusion, which can reduce complication rates, minimize fat necrosis, and flap failure. This study summarizes our experience with using unipedicled and bipedicled DIEP flaps for breast reconstruction.Patients and MethodsA total of 168 consecutive patients undergoing unilateral breast reconstruction with DIEP flaps over a 3‐year period were retrospectively reviewed. Primary microvascular anastomoses were performed to the thoracodorsal vessels in both unipedicled and bipedicled DIEP groups. In bipedicled DIEP flap cases, additional secondary microvascular anastomoses were performed either by extraflap or intraflap options. Clinical characteristics and outcomes were recorded.ResultsUnipedicled (n = 89; 53%) and bipedicled flaps were used. Both groups were comparable for mean age, diabetes mellitus, hypertension, smoking, and chemotherapy. BMI was 24.9 ± 3.6 in the unipedicled group and 22.8 ± 2.9 in the bipedicled group (p < .001). The surgical duration was longer in bipedicled group (367 ± 86.5 minu vs 403.7 ± 65.6 min, p < .05) but incidence of fat necrosis decreased in the bipedicle group (24 patients [27%] vs. 7 patients [8.9%] p < .05). There was no flap loss or instance of abdominal hernia in any group.ConclusionsThe bipedicled DIEP flaps may be a feasible option for large breast reconstruction in thin patients. However, the additional microsurgical technical complexity and longer operative time must be considered.</description><subject>Blood vessels</subject><subject>Breast</subject><subject>Chemotherapy</subject><subject>Diabetes mellitus</subject><subject>Hernia</subject><subject>Hypertension</subject><subject>Mastectomy</subject><subject>Microvasculature</subject><subject>Necrosis</subject><subject>Perfusion</subject><issn>0738-1085</issn><issn>1098-2752</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><recordid>eNqNjU1OwzAQhS0EEuVnwwlGYp0yjpMmYYcQqAeAdeU6k-LK2GZst-plOCtZILFl9fT0Pb1PiDuJS4lYP3xaw0uFK5RnYiFx6Ku6a-tzscBO9ZXEvr0UVyntEXEYumEhvt-9dToTawe65ODCLpQEWyadMjCZ4FPmYrINHo42f0DxNtJojaMRtB9h-1dHogjWT8Q2MFC0u_mErQHNs-EEkXgKrPMMJ6fjIzzNhoOlI4QJ5KoHoxMlCAdiUCfSnG7ExaRdotvfvBb3ry9vz-sqcvgqlPJmHwr7GW3qpqmHRrWqU_9b_QC2c2Jb</recordid><startdate>20200901</startdate><enddate>20200901</enddate><creator>Yoon Jae Lee</creator><creator>Kim, SeongAe</creator><creator>Suk‐Ho Moon</creator><creator>Young, Joon Jun</creator><creator>Rhie, Jong Won</creator><creator>Deuk Young Oh</creator><general>Wiley Subscription Services, Inc</general><scope>7QO</scope><scope>7T5</scope><scope>7T7</scope><scope>7TK</scope><scope>8FD</scope><scope>C1K</scope><scope>FR3</scope><scope>H94</scope><scope>K9.</scope><scope>P64</scope></search><sort><creationdate>20200901</creationdate><title>Unilateral autologous breast reconstruction with unipedicled and bipedicled deep inferior epigastric artery perforator flap: A review of 168 cases over 3years</title><author>Yoon Jae Lee ; Kim, SeongAe ; Suk‐Ho Moon ; Young, Joon Jun ; Rhie, Jong Won ; Deuk Young Oh</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-proquest_journals_24429435373</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Blood vessels</topic><topic>Breast</topic><topic>Chemotherapy</topic><topic>Diabetes mellitus</topic><topic>Hernia</topic><topic>Hypertension</topic><topic>Mastectomy</topic><topic>Microvasculature</topic><topic>Necrosis</topic><topic>Perfusion</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Yoon Jae Lee</creatorcontrib><creatorcontrib>Kim, SeongAe</creatorcontrib><creatorcontrib>Suk‐Ho Moon</creatorcontrib><creatorcontrib>Young, Joon Jun</creatorcontrib><creatorcontrib>Rhie, Jong Won</creatorcontrib><creatorcontrib>Deuk Young Oh</creatorcontrib><collection>Biotechnology Research Abstracts</collection><collection>Immunology Abstracts</collection><collection>Industrial and Applied Microbiology Abstracts (Microbiology A)</collection><collection>Neurosciences Abstracts</collection><collection>Technology Research Database</collection><collection>Environmental Sciences and Pollution Management</collection><collection>Engineering Research Database</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><jtitle>Microsurgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Yoon Jae Lee</au><au>Kim, SeongAe</au><au>Suk‐Ho Moon</au><au>Young, Joon Jun</au><au>Rhie, Jong Won</au><au>Deuk Young Oh</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Unilateral autologous breast reconstruction with unipedicled and bipedicled deep inferior epigastric artery perforator flap: A review of 168 cases over 3years</atitle><jtitle>Microsurgery</jtitle><date>2020-09-01</date><risdate>2020</risdate><volume>40</volume><issue>6</issue><spage>663</spage><epage>669</epage><pages>663-669</pages><issn>0738-1085</issn><eissn>1098-2752</eissn><abstract>BackgroundHarvesting a DIEP flap based on bipedicled perforators can enhance vascular perfusion, which can reduce complication rates, minimize fat necrosis, and flap failure. This study summarizes our experience with using unipedicled and bipedicled DIEP flaps for breast reconstruction.Patients and MethodsA total of 168 consecutive patients undergoing unilateral breast reconstruction with DIEP flaps over a 3‐year period were retrospectively reviewed. Primary microvascular anastomoses were performed to the thoracodorsal vessels in both unipedicled and bipedicled DIEP groups. In bipedicled DIEP flap cases, additional secondary microvascular anastomoses were performed either by extraflap or intraflap options. Clinical characteristics and outcomes were recorded.ResultsUnipedicled (n = 89; 53%) and bipedicled flaps were used. Both groups were comparable for mean age, diabetes mellitus, hypertension, smoking, and chemotherapy. BMI was 24.9 ± 3.6 in the unipedicled group and 22.8 ± 2.9 in the bipedicled group (p < .001). The surgical duration was longer in bipedicled group (367 ± 86.5 minu vs 403.7 ± 65.6 min, p < .05) but incidence of fat necrosis decreased in the bipedicle group (24 patients [27%] vs. 7 patients [8.9%] p < .05). There was no flap loss or instance of abdominal hernia in any group.ConclusionsThe bipedicled DIEP flaps may be a feasible option for large breast reconstruction in thin patients. However, the additional microsurgical technical complexity and longer operative time must be considered.</abstract><cop>Hoboken</cop><pub>Wiley Subscription Services, Inc</pub><doi>10.1002/micr.30601</doi></addata></record> |
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| source | Wiley Online Library - AutoHoldings Journals |
| subjects | Blood vessels Breast Chemotherapy Diabetes mellitus Hernia Hypertension Mastectomy Microvasculature Necrosis Perfusion |
| title | Unilateral autologous breast reconstruction with unipedicled and bipedicled deep inferior epigastric artery perforator flap: A review of 168 cases over 3years |
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