The deep inferior epigastric perforator (DIEP) flap is considered to be the gold standard for autologous breast reconstruction. This study evaluates the outcome of unilateral DIEP flap reconstructions, comparing university with a community hospital setting. A total of 77 unilateral DIEP flaps were performed at one university hospital and two community hospitals by the same two surgeons. Outcome parameters were: hospital stay, operating time, wound infection, wound dehiscence, fat necrosis, haematoma, (partial) flap necrosis and the need for surgical intervention. Forty-nine unilateral DIEP flaps were performed in the university hospital and 28 in the community hospitals. Baseline characteristics were equal. No significant difference was found in total complication rate, flap loss or need for surgical intervention. Although wound dehiscence occurred more often in the community hospitals, unilateral DIEP flap breast reconstructions can be performed with a comparable degree of safety and complication risk in both university and community hospital settings.
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http://dx.doi.org/10.3109/2000656X.2012.686915 | DOI Listing |
J Plast Reconstr Aesthet Surg
February 2024
Plastic Surgery Department, St Thomas' Hospital, Guy's and St Thomas' NHS Foundation Trust, London, UK. Electronic address:
Background: Autologous breast reconstruction patients require thorough assessment, with the profunda femoris artery perforator (PAP) flap having become an important autologous reconstruction option alongside the deep inferior epigastric perforator (DIEP) flap. Breast reconstruction impacts patients psychologically, physically and mentally. The BREAST-Q aids in the assessment of patient-reported outcome measures (PROMs).
View Article and Find Full Text PDFPlast Reconstr Surg
December 2024
Plastic and Reconstructive Surgery Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY.
Background: Enhanced Recovery After Surgery (ERAS) protocols can reduce the length of stay (LOS) for surgical patients, including those undergoing unilateral deep inferior epigastric artery perforator (DIEP) flap breast reconstruction, allowing most patients to be discharged by postoperative day 2. However, some patients require a prolonged inpatient stay due to difficulty completing postoperative milestones. This study aims to identify factors associated with increased LOS after DIEP flap breast reconstruction and assess safety of earlier discharge.
View Article and Find Full Text PDFPlast Reconstr Surg Glob Open
December 2024
From the Division of Surgery and Interventional Science, University College London, London, United Kingdom.
Background: The deep inferior epigastric perforator (DIEP) flap provides an effective and popular means for autologous breast reconstruction. However, with the complexity of the pathway, the environmental impact of the pathway has yet to be evaluated.
Methods: A retrospective analysis of 42 unilateral DIEPs at a single reconstructive center was performed.
Plast Reconstr Surg Glob Open
December 2024
From the Department of Plastic, Reconstructive and Aesthetic Surgery, Nippon Medical School Hospital, Tokyo, Japan.
Background: There are advantages and disadvantages to both immediate 1-stage and 2-stage autologous-breast reconstruction. The 2-stage procedure may suffer from a hitherto overlooked difficulty: the tissue expander may induce chest wall depression that may require using a heavier-than-expected flap to generate symmetrical breasts. We conducted a retrospective observational study to assess this phenomenon.
View Article and Find Full Text PDFJ Reconstr Microsurg
December 2024
Plastic Surgery, University of Virginia Health System, Charlottesville, United States.
Background: Enhanced Recovery After Surgery (ERAS) pathways have been widely implemented across many surgical practices, including autologous breast reconstruction. However, the benefits of ERAS in the morbidly obese population have yet to be defined.
Methods: A retrospective chart review of patients undergoing deep inferior epigastric artery perforator (DIEP) flap breast reconstruction at our institution from 2017 to 2022 was performed.
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