Outcomes of Take-Back Operations in Breast Reconstruction with Free Lower Abdominal Flaps
BackgroundMicrovascular complications after free-flap breast reconstructions are potentially devastating problems that can increase patient morbidity and lead to flap loss. To date, no comprehensive study has examined the rates of salvage and the methods of microvascular revision in breast reconstru...
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Korean Society of Plastic and Reconstructive Surgeons
2015-11-01
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doaj-d3d95eb4bc8a42928574781e5001feac2020-11-24T23:27:09ZengKorean Society of Plastic and Reconstructive SurgeonsArchives of Plastic Surgery2234-61632234-61712015-11-0142674174510.5999/aps.2015.42.6.741602Outcomes of Take-Back Operations in Breast Reconstruction with Free Lower Abdominal FlapsJi Hong Yim0Jiyoung Yun1Taik Jong Lee2Eun Key Kim3Jonghan Cho4Jin Sup Eom5Department of Plastic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.Department of Plastic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.Department of Plastic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.Department of Plastic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.Seoul Plastic Surgery Clinic, Gangneung, Korea.Department of Plastic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.BackgroundMicrovascular complications after free-flap breast reconstructions are potentially devastating problems that can increase patient morbidity and lead to flap loss. To date, no comprehensive study has examined the rates of salvage and the methods of microvascular revision in breast reconstruction. We reviewed the treatment of microvascular complications of free-flap breast reconstruction procedures over a seven-year period.MethodsA retrospective review of all patients who underwent microvascular breast reconstruction at our institution between April 2006 and December 2013 was conducted. Based on their surgical records, all patients who required emergency re-exploration were identified, the rate of flap salvage was determined, the factors associated with flap salvage were evaluated, and the causes and methods of revision were reviewed.ResultsDuring the review period, 605 breast reconstruction procedures with a free lower abdominal flap were performed. Seventeen of these flaps were compromised by microvascular complications, and three flaps were lost. The overall salvage rate was 82.35%. No significant differences between the salvaged group and the failed group were observed with regard to age, BMI, axillary dissection, number of anastomotic arteries and veins, recipient vessel types, or use of the superficial inferior epigastric vein in the revision operation. Successful salvage of the flap was associated with a shorter time period between recognizing the signs of flap compromise and the take-back operation.ConclusionsThe salvage rate of compromised lower abdominal flaps was high enough to warrant attempting re-exploration. Immediate intervention after the onset of flap compromise signs is as important as vigilant postoperative monitoring.http://www.e-aps.org/upload/pdf/aps-42-741.pdfPerforator flapSurgical flapsFree tissue flapsSalvage therapyBreast |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Ji Hong Yim Jiyoung Yun Taik Jong Lee Eun Key Kim Jonghan Cho Jin Sup Eom |
spellingShingle |
Ji Hong Yim Jiyoung Yun Taik Jong Lee Eun Key Kim Jonghan Cho Jin Sup Eom Outcomes of Take-Back Operations in Breast Reconstruction with Free Lower Abdominal Flaps Archives of Plastic Surgery Perforator flap Surgical flaps Free tissue flaps Salvage therapy Breast |
author_facet |
Ji Hong Yim Jiyoung Yun Taik Jong Lee Eun Key Kim Jonghan Cho Jin Sup Eom |
author_sort |
Ji Hong Yim |
title |
Outcomes of Take-Back Operations in Breast Reconstruction with Free Lower Abdominal Flaps |
title_short |
Outcomes of Take-Back Operations in Breast Reconstruction with Free Lower Abdominal Flaps |
title_full |
Outcomes of Take-Back Operations in Breast Reconstruction with Free Lower Abdominal Flaps |
title_fullStr |
Outcomes of Take-Back Operations in Breast Reconstruction with Free Lower Abdominal Flaps |
title_full_unstemmed |
Outcomes of Take-Back Operations in Breast Reconstruction with Free Lower Abdominal Flaps |
title_sort |
outcomes of take-back operations in breast reconstruction with free lower abdominal flaps |
publisher |
Korean Society of Plastic and Reconstructive Surgeons |
series |
Archives of Plastic Surgery |
issn |
2234-6163 2234-6171 |
publishDate |
2015-11-01 |
description |
BackgroundMicrovascular complications after free-flap breast reconstructions are potentially devastating problems that can increase patient morbidity and lead to flap loss. To date, no comprehensive study has examined the rates of salvage and the methods of microvascular revision in breast reconstruction. We reviewed the treatment of microvascular complications of free-flap breast reconstruction procedures over a seven-year period.MethodsA retrospective review of all patients who underwent microvascular breast reconstruction at our institution between April 2006 and December 2013 was conducted. Based on their surgical records, all patients who required emergency re-exploration were identified, the rate of flap salvage was determined, the factors associated with flap salvage were evaluated, and the causes and methods of revision were reviewed.ResultsDuring the review period, 605 breast reconstruction procedures with a free lower abdominal flap were performed. Seventeen of these flaps were compromised by microvascular complications, and three flaps were lost. The overall salvage rate was 82.35%. No significant differences between the salvaged group and the failed group were observed with regard to age, BMI, axillary dissection, number of anastomotic arteries and veins, recipient vessel types, or use of the superficial inferior epigastric vein in the revision operation. Successful salvage of the flap was associated with a shorter time period between recognizing the signs of flap compromise and the take-back operation.ConclusionsThe salvage rate of compromised lower abdominal flaps was high enough to warrant attempting re-exploration. Immediate intervention after the onset of flap compromise signs is as important as vigilant postoperative monitoring. |
topic |
Perforator flap Surgical flaps Free tissue flaps Salvage therapy Breast |
url |
http://www.e-aps.org/upload/pdf/aps-42-741.pdf |
work_keys_str_mv |
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