Objective: To evaluate retrospectively the morbidity of four different surgical procedures for immediate breast reconstruction (IBR) in the setting of neoadjuvant chemotherapy and radiotherapy, and to determine which procedure is best adapted to these circumstances.
Patients And Methods: Immediate breast reconstruction was undertaken in 101 patients who had undergone neoadjuvant chemotherapy and radiotherapy for invasive breast carcinoma. IBR was accomplished by transverse rectus abdominis musculocutaneous flap (TRAM) in 38 patients, by latissimus dorsi musculocutaneous flap with prosthesis (LDMP) in 32, by autologous latissimus dorsi musculocutaneous flap (ALDM) in 15, and by simple prosthetic implant in 26.
Results: The complication rates for TRAM. LDMP, ALDM and prosthesis were respectively 50%, 37.5%, 85%, and 62%. The need for additional surgical procedure(s) was respectively 29%, 15%, 6%, and 56%. The complication rate was significantly worse (p=0.013) for ALDM (RR=1.73, IC95%=1.12-2.69), and the need for surgical revision was worst (p=0.00087).for simple prosthetic implant (RR=1.99, IC95%=1.11-3.59).
Conclusion: IBR using musculocutaneous flap is superior to the use of prosthetic implant in patients having undergone neoadjuvant chemotherapy and radiotherapy.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/s0021-7697(07)79777-6 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
DIEP flap reconstruction for sacrectomy defects: Two case reports.
Ann Chir Plast Esthet
January 2025
Department of Plastic, Reconstructive and Aesthetic surgery, Hôpital de Hautepierre, Strasbourg University Hospital, 1, avenue Molière, Strasbourg, 67200 cedex, France; ICube, CNRS UMR 7357, MMB, University of Strasbourg, Strasbourg, 67091 cedex, France.
Introduction: Vertical rectus abdominis myocutaneous (VRAM) flap is the most common option for large sacral defect reconstruction but is known to have donor-site abdominal morbidity compared to deep inferior epigastric perforator (DIEP) flaps.
Report: Fifty-seven and 63 year-old men were admitted for large sacral soft tissue defects after tumour excisions. They both underwent an inferiorly based pedicled vertical DIEP flap passed transabdominally with successful postoperative outcomes and not any abdominal wall complication.
Negative pressure wound therapy on a musculocutaneous free flap in no skin edge wound bed: A case report.
Int J Surg Case Rep
January 2025
Department of Plastic and Breast Surgery, Aarhus University Hospital, Denmark.
Introduction: Necrotising soft tissue infection (NSTI) is an exceptionally dangerous infectious disease targeting soft tissues with high mortality as well as morbidity. The aim of reconstructive surgery after initial debridement is to maintain function as well as to achieve a satisfactory cosmetic result.
Presentation Of Case: A 50-year-old male presented with necrotising soft tissue infection on the thorax and left upper arm following mastectomy for breast cancer.
Utility of large V-Y advancement of the latissimus dorsi myocutaneous flap in the reconstruction of large thoracic defects: a case series and literature review.
JPRAS Open
March 2025
Sir Charles Gairdner Hospital, Nedlands, Perth, Western Australia, 6009.
Background: Trunk reconstruction following sarcoma excision involves significant defects. Pedicled and free latissimus dorsi myocutaneous flap (LDMF) reconstruction is commonly employed for thoracic defects; however, skin paddle design is limited to 10-12 cm to achieve primary donor closure. Paucity of data exists regarding the utility of V-Y advancement of LDMF, previously described for moderately sized thoracic defects.
View Article and Find Full Text PDFHair Transplantation on the Baldness Region with Free Latissimus Dorsi Flap for Scalp Reconstruction: A Case Report.
Arch Plast Surg
January 2025
Department of Plastic and Reconstructive Surgery, Seoul National University Boramae Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea.
Scalp reconstruction, particularly with complex defects and infection risks, often favors microvascular free flaps. However, this method can result in unavoidable alopecia and undesirable aesthetics. This report describes a novel case where hair transplantation via follicular unit extraction (FUE) was applied to a free myocutaneous flap.
View Article and Find Full Text PDFInfrahyoid myocutaneous flap for reconstruction in head and neck cancer patients.
Natl J Maxillofac Surg
November 2024
Department of Radiation Oncology, Dr. RMLIMS, Lucknow, Uttar Pradesh, India.
Background: Reconstruction of head and neck defects following tumor excision is one of the most challenging surgeries due to multiple reasons, such as associated cosmetic and functional impairments. The three-dimensional aspect of the defect makes it more difficult. Although in modern settings, microvascular surgery is preferred in many conditions, it requires the presence of resources and expertise.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!