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Diep flap surgery

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https://www.readbyqxmd.com/read/29369978/venous-superdrainage-in-diep-flap-breast-reconstruction-the-impact-of-superficial-inferior-epigastric-vein-dissection-on-abdominal-seroma-formation
#1
Jakob Nedomansky, Stefanie Nickl, Christine Radtke, Werner Haslik, Klaus F Schroegendorfer
BACKGROUND: Abdominal seroma formation after deep inferior epigastric perforator (DIEP) flap breast reconstruction is a common donor-site complication. Additional dissection of one or both of the superficial inferior epigastric veins (SIEVs) in DIEP flap breast reconstruction allows an additional anastomosis for venous superdrainage if venous congestion occurs. However, generally, SIEV dissection involves greater invasiveness into the inguinal region, which can traumatize lymphatic tissue and lead to lymph accumulation...
February 2018: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/29369109/is-unipedicled-transverse-rectus-abdominis-myocutaneous-flap-obsolete-owing-to-superiority-of-diep-flap
#2
Mark M Leyngold
BACKGROUND: Pedicled transverse rectus abdominis myocutaneous (TRAM) flap was developed by Hartrampf in 1982 for breast reconstruction. Since deep inferior epigastric perforator (DIEP) flap was popularized, it has become the criterion standard for abdominally based breast reconstruction owing to its low donor site morbidity, excellent cosmetic outcomes, and high success rates. The purpose of this review is to determine if a unilateral pedicle TRAM flap has become obsolete to DIEP flap...
January 24, 2018: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29368352/robotic-assisted-deep-inferior-epigastric-artery-perforator-flap-abdominal-harvest-for-breast-reconstruction-a-case-report
#3
Vinay S Gundlapalli, Adeyemi A Ogunleye, Kiandra Scott, Eric Wenzinger, Jason P Ulm, Lance Tavana, Rana C Pullatt, Kevin O Delaney
The deep inferior epigastric perforator (DIEP) flap is a mainstay of autologous breast reconstruction. The da Vinci robot has recently been adapted for an increasing number of reconstructive surgeries. The literature has yet to describe its use for the intra-abdominal harvest of the deep inferior epigastric vessels (DIEV) during DIEP flap breast reconstruction. We show the use of the da Vinci robotic surgical system for the intra-abdominal dissection of DIEV during delayed breast reconstruction with a DIEP flap in a 51-year-old female who had undergone a right modified radical mastectomy...
January 25, 2018: Microsurgery
https://www.readbyqxmd.com/read/29335394/landscape-of-oncoplastic-breast-surgery-across-poland
#4
Agnieszka Kolacinska, Diana Hodorowicz-Zaniewska, Artur Bocian, Dariusz Michalik, Rafal Matkowski, Andrzej Kurylcio, Pawel Pyka, Michal Charytonowicz, Maciej Berkan
Oncoplastic and reconstructive techniques are essential tools in the armamentarium of contemporary breast surgeons. The aim of the study was to identify oncoplastic reconstructive patterns in breast cancer centers across Poland. A questionnaire of 18 questions was sent by email to the members of the Polish Society of Surgical Oncology and the Polish Society of Plastic, Reconstructive and Esthetic Surgery via their dedicated websites. The numbers of breast cancer patients operated on in each center ranged from 120 to 904 per year...
December 30, 2017: Polski Przeglad Chirurgiczny
https://www.readbyqxmd.com/read/29221853/venous-thromboembolism-events-after-breast-reconstructions-with-diep-free-flaps-in-192-consecutive-case
#5
A Modarressi, A-V Schettini, E M Rüegg, B Pittet-Cuénod
BACKGROUND: Patient candidates for breast reconstruction with free deep inferior epigastric perforator flap (DIEP) may present several risk factors for venous thromboembolism (VTE). Risk identification is essential for appropriate VTE prophylaxis measures to be put in place. This study aims to investigate VTE incidence after DIEP flap breast reconstruction and to assess the accuracy of the Caprini Risk Assessment Model (RAM), which is the unique score validated to assess the VTE risk for plastic surgery procedures and identify patients at high VTE risk...
February 2018: Annales de Chirurgie Plastique et Esthétique
https://www.readbyqxmd.com/read/29184728/diep-flap-breast-reconstruction-in-patients-with-breast-ptosis-2-stage-reconstruction-using-3-dimensional-surface-imaging-and-a-printed-mold
#6
Koichi Tomita, Kenji Yano, Mifue Taminato, Michiko Nomori, Ko Hosokawa
Background: Autologous breast reconstruction can be performed for breasts with ptosis to a certain extent, but if patients desire to correct ptosis, mastopexy of the contralateral breast is indicated. However, accurate prediction of post-mastopexy breast shape is difficult to make, and symmetrical breast reconstruction requires certain experience. We have previously reported the use of three-dimensional (3D) imaging and printing technologies in deep inferior epigastric artery perforator (DIEP) flap breast reconstruction...
October 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/29166926/protocol-for-a-systematic-review-and-meta-analysis-on-the-clinical-outcomes-and-cost-of-deep-inferior-epigastric-perforator-diep-flap-versus-implants-for-breast-reconstruction
#7
Ankur Khajuria, Oliver J Smith, Maxim Prokopenko, Maximillian Greenfield, Afshin Mosahebi
BACKGROUND: Mastectomy in the context of breast malignancy can have a profoundly negative impact on a woman's self-image, impairing personal, sexual and social relationships. The deep inferior epigastric perforator (DIEP) flap and implants are the two commonest reconstructive modalities that can potentially overcome this psychological trauma. The comparative data on clinical outcomes and costs of the two modalities is limited. We aim to synthesise the current evidence on DIEP versus implants to establish which is the superior technique for breast reconstruction, in terms of clinical outcomes and cost-effectiveness...
November 22, 2017: Systematic Reviews
https://www.readbyqxmd.com/read/28972286/foot-and-ankle-reconstruction-with-vertically-designed-deep-inferior-epigastric-perforator-flap
#8
Osman Akdag, Mehtap Karamese, Gokce Unal Yıldıran, Mustafa Sutcu, Zekeriya Tosun
INTRODUCTION: The deep inferior epigastric perforator (DIEP) flap is one of the most commonly utilized flaps of reconstructive surgery. Although the horizontal flap design is the most commonly used, this flap can be vertically designed to avoid drawbacks such as excessive tissue dissection, relatively reduced flap perfusion, and scarification of the contralateral flap opportunity. The aim of this report is to present our case series for foot and ankle reconstruction with vertical designed DIEP flap...
October 3, 2017: Microsurgery
https://www.readbyqxmd.com/read/28882494/the-merits-of-decision-modelling-in-the-earliest-stages-of-the-ideal-framework-an-innovative-case-in-diep-flap-breast-reconstructions
#9
S Hummelink, J G W Gerrits, L J Schultze Kool, D J O Ulrich, M M Rovers, J P C Grutters
BACKGROUND: The IDEAL framework aims at improving the evidence base of available surgical innovations. However, the development of such innovations and collection of evidence is costly. Surgical innovation can provide more value for money if innovations are evaluated at an early stage, where evaluations can inform the decision whether to stop or to further develop an innovation. We illustrate how decision modelling can be readily adopted at the earliest stages (0-1) of the IDEAL framework, using an innovation in bilateral DIEP flap breast reconstruction as an example...
August 7, 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/28867912/deep-inferior-epigastric-perforator-free-flaps-for-use-in-complicated-groin-wound-repair-a-case-report-of-severe-groin-scar-contracture-and-review-of-pedicled-and-free-flaps-in-groin-wound-repair
#10
James D Kotick, Roger S Sandelin, Richard D Klein
The use of pedicled and free flaps for tissue transfer and coverage has become a common practice in modern plastic surgery. An area that presents considerable challenge for tissue coverage is the groin. Defects in this area are complicated by issues such as prior surgery; scar contracture; extension of the defect beyond the borders of the groin; radiation damage; high probability of infection; and involvement of vital underlying structures, the genitalia, and perineal and perianal area. Therefore, the choice of donor site and flap usage is often difficult...
August 2017: Journal of Hand and Microsurgery
https://www.readbyqxmd.com/read/28862114/immediate-delayed-autologous-ideal-breast-reconstruction-with-the-diep-flap
#11
Sonia Fertsch, Beatrix Munder, Mazen Hagouan, Tino Schulz, Oliver Thamm, Peter Stambera, Alina Abu-Ghazaleh, Julia Schaberick, Christoph Andree
Background: The most common cancer worldwide in women is breast cancer. The increasing number of cases each year, requires a novel curative approach that can combine oncological treatments and breast reconstruction yielding a pleasing and aesthetic breast that is a definitive and long lasting solution. Thus, the Immediate-DElayed AutoLogous (IDEAL) breast reconstruction principle was created to hold up to the standards of the needs of contemporary women. METHOD: The IDEAL protocol for breast reconstruction was developed in our department in cooperation with our breast surgery unit and describes a two-stage approach that implicates neoadjuvant radio-/ chemotherapy treatment regimes and tumor staging before the mastectomy in order to avoid post-mastectomy radiation...
July 2017: Chirurgia
https://www.readbyqxmd.com/read/28861376/patient-determinants-as-independent-risk-factors-for-postoperative-complications-of-breast-reconstruction
#12
Andri Thorarinsson, Victoria Fröjd, Lars Kölby, Mattias Lidén, Anna Elander, Hans Mark
BACKGROUND: Breast reconstruction is an essential component in the treatment of breast cancer. Postoperative complications after breast reconstruction are common and affect patient satisfaction. Determining independent risk factors using patient characteristics could be advantageous for patient assessment and counseling. METHODS: We retrospectively enrolled 623 consecutive patients who underwent reconstruction with a deep inferior epigastric perforator flap (DIEP), latissimus dorsi flap (LD), lateral thoracodorsal flap (LTDF), or tissue expander with a secondary implant (EXP) in this study...
August 2017: Gland Surgery
https://www.readbyqxmd.com/read/28758229/time-dependent-factors-in-diep-flap-breast-reconstruction
#13
Rosaria Laporta, Benedetto Longo, Michail Sorotos, Alessio Farcomeni, Vittoria Amorosi, Fabio Santanelli di Pompeo
BACKGROUND: The process of harvesting and performing microsurgical anastomosis may lengthen deep inferior epigastric artery perforator (DIEP) flap breast reconstruction affecting results and patient safety. The aim of the study was to investigate the associations between predictors and operative time (OT). METHODS: Between 2004 and 2016, 336 immediate and 68 delayed unilateral reconstructions were performed in 404 patients. Age, weight, height, body mass index (BMI), nulliparity, or pluriparity condition were collected to determine the impact of patient characteristics on OT...
July 24, 2017: Microsurgery
https://www.readbyqxmd.com/read/28703885/use-of-a-72-cm-long-extended-bilateral-deep-inferior-epigastric-artery-perforator-free-flap-for-reconstruction-of-a-lower-leg-with-no-suitable-recipient-vessel-around-the-injury-zone-a-case-report
#14
Hidehiko Yoshimatsu, Takumi Yamamoto, Akitatsu Hayashi, Takuya Iida
In free-flap reconstruction of the lower extremity, due either to trauma or pre-existing vascular disease, healthy vessels may not be readily available in the proximity of the defect. A variety of options including a cross-leg free flap, vein grafts, arteriovenous loops, and "bridging" flaps have been used to address the issue. The purpose of this report is to present a case in which a 72-cm long extended bilateral deep inferior epigastric artery perforator (DIEP) free flap was used for coverage of a 20 × 25 cm soft tissue defect of the lower leg following a Gustilo grade IIIC fracture in a 29-year-old man...
July 13, 2017: Microsurgery
https://www.readbyqxmd.com/read/28695998/co-surgeons-in-breast-reconstructive-microsurgery-what-do-they-bring-to-the-table
#15
Nicholas T Haddock, Samar Kayfan, Ronnie A Pezeshk, Sumeet S Teotia
INTRODUCTION: Current research within other surgical specialties suggests that a co-surgeon approach may reduce operative times and complications associated with complex bilateral procedures, possibly leading to improved patient and surgical outcomes. We sought to evaluate the role of the co-surgery team and its development in free flap breast reconstruction. METHODS: A retrospective review of free-flap breast reconstruction by two surgeons from 2011 to 2016 was conducted...
January 2018: Microsurgery
https://www.readbyqxmd.com/read/28693999/-profunda-artery-perforator-flap-reliable-secondary-option-for-breast-reconstruction
#16
P Fosseprez, A Gerdom, M Servaes, C Deconinck, G Pirson, A Berners
BACKGROUND: In recent years, the DIEP-flap has become the standard for autologous breast reconstruction. However, when abdominal donor site is unavailable, secondary options are numerous. This report documents our experience with PAP-flap breast reconstruction. METHOD: We carried out a retrospective study of patients who underwent reconstructive breast surgery by PAP-flaps in our institution since 2014. RESULTS: Seventeen PAP-flaps were carried out in 15 patients, two of which received consecutive reconstruction of each breast at distinct intervals...
July 7, 2017: Annales de Chirurgie Plastique et Esthétique
https://www.readbyqxmd.com/read/28684286/donor-site-morbidity-in-diep-free-flap-breast-reconstructions-a-comparison-of-unilateral-bilateral-and-bipedicled-surgical-procedure-types
#17
COMPARATIVE STUDY
Taj Tomouk, Anita T Mohan, Alex Azizi, Elena Conci, Elizabeth B Brickley, Charles M Malata
BACKGROUND: The use of abdominal tissue in post-mastectomy autologous breast reconstruction is a popular choice among reconstructive surgeons. This is the first study to evaluate donor complications comparing unilateral, bilateral, and bipedicled DIEP breast reconstructions. METHODS: A retrospective chart review was conducted of all women undergoing rib-preserving DIEP free flap breast reconstruction at a University Hospital between 2008 and 2015 by the senior surgeon (CMM)...
November 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/28654582/predictors-classification-and-management-of-umbilical-complications-in-diep-flap-breast-reconstruction
#18
Min-Jeong Cho, Sumeet S Teotia, Nicholas T Haddock
BACKGROUND: In recent years, the deep inferior epigastric perforator (DIEP) flap has become the workhorse flap for autologous breast reconstruction. Despite increased reports on DIEP flaps, umbilical complications have not been previously studied. The aesthetics of the umbilicus dictates the beauty of the abdomen, and it is critical for plastic surgeons to minimize the scarring of the umbilicus. In this study, we retrospectively reviewed patients who underwent DIEP flaps to determine the predictors of umbilical complications, and created a classification system of these wounds...
July 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28528800/an-innovative-method-of-planning-and-displaying-flap-volume-in-diep-flap-breast-reconstructions
#19
S Hummelink, Arico C Verhulst, Thomas J J Maal, Yvonne L Hoogeveen, Leo J Schultze Kool, Dietmar J O Ulrich
BACKGROUND: Determining the ideal volume of the harvested flap to achieve symmetry in deep inferior epigastric artery perforator (DIEP) flap breast reconstructions is complex. With preoperative imaging techniques such as 3D stereophotogrammetry and computed tomography angiography (CTA) available nowadays, we can combine information to preoperatively plan the optimal flap volume to be harvested. In this proof-of-concept, we investigated whether projection of a virtual flap planning onto the patient's abdomen using a projection method could result in harvesting the correct flap volume...
July 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/28470029/diep-flap-breast-reconstruction-preserving-a-lumbar-peritoneal-shunt-tube
#20
Kentarou Ueki, Katsuhiro Yoshikawa, Tatsuki Enoshiri, Masahiro Tanji, Megumi Takeuchi, Shigehiko Suzuki
We herein report a case of immediate deep inferior epigastric perforator flap (DIEP flap) breast reconstruction surgery in a 50-year-old female patient with a lumbar peritoneal shunt tube. We performed DIEP flap reconstruction in the patient by withdrawing and subsequently reinserting the abdominal side of an implanted shunt tube.
2017: Case Reports in Plastic Surgery & Hand Surgery
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