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Autologous Breast Reconstruction

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https://www.readbyqxmd.com/read/29750763/-relationship-between-tamoxifen-and-the-absorption-of-subfascial-autologous-fat-grafts
#1
Alfredo B D Silva, Felipe Haupenthal, André D Morais, Adriana S K Ascenço, Ana P M Sebastião, Manoel A R Cavalcanti, Renato S Freitas
INTRODUCTION: In the lipofilling procedures used in breast reconstruction, there is an unpredictability in the rate of reabsorption of the grafted fat. The objective of this study was to analyze the effect of Tamoxifen, a medication commonly prescribed for patients with breast cancer, as a possible alternative to reduce the rate of autologous fat graft resorption. MATERIALS AND METHODS: The fatty cushion of the inguinal region of 20 female adult Wistar rats was removed and then autografted, using a standard volume of 0...
March 15, 2018: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/29750761/-toradol%C3%A2-following-breast-surgery-is-there-an-increased-risk-of-hematoma
#2
Brittany N Nguyen, Ruth J Barta, Christine Stewart, Cherrie A Heinrich
BACKGROUND: Ketorolac tromethamine (Toradol), a nonsteroidal antiinflammatory drug, is used with increased frequency given its success in postoperative pain control and the subsequent decreased need for narcotics. Its use has been limited in plastic surgery for fear of postoperative bleeding and hematoma formation. In this study of breast surgery patients, we investigated whether ketorolac increased the risk of postoperative hematoma formation. METHODS: After obtaining institutional review board approval, we retrospectively reviewed the records of patients undergoing breast surgery (breast reduction and autologous or implant based reconstruction) from January 2012 through December 2014...
March 15, 2018: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/29750760/prospective-randomized-controlled-comparison-of-local-anesthetic-infusion-pump-versus-depofoam-bupivacaine-for-pain-management-after-unilateral-delayed-deep-inferior-epigastric-perforator-free-flap-reconstruction
#3
James Gatherwright, Rebecca Knackstedt, Amir Ghaznavi, Steven Bernard, Graham Schwarz, Andrea Moreira, Raffi Gurunluoglu, Risal Djohan
BACKGROUND: Effective postsurgical analgesia is a critical aspect of patient recovery. The goal of this prospective, randomized, controlled, blinded study was to examine the effect that liposomal bupivacaine delivered via a transversus abdominis plane (TAP) block has on pain control in women undergoing unilateral deep inferior epigastic perforator reconstruction. METHODS: IRB approval was granted for this prospective study. Patients were eligible if they were undergoing unilateral, delayed DIEP reconstruction...
March 15, 2018: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/29750758/quality-of-surgical-outcomes-reporting-in-plastic-surgery-a-15-year-analysis-of-complication-data
#4
Rajiv P Parikh, Ketan Sharma, Ali A Qureshi, Michael J Franco, Terence M Myckatyn
BACKGROUND: Postoperative complication data are integral to assessing patient outcomes and identifying areas to improve quality in surgical care. Accurate appraisal of surgical techniques requires consistency and reliability in complication data reporting. The purpose of this study was to analyze the quality of complication reporting in plastic surgery. METHODS: The authors critically reviewed the literature from January 1st, 2000 to December 31st, 2014 to identify articles reporting surgical outcomes after 3 index procedures (autologous breast reconstruction, prosthetic breast reconstruction and reduction mammaplasty)...
March 15, 2018: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/29746276/deepithelialized-skin-reduction-preserves-skin-and-nipple-perfusion-in-immediate-reconstruction-of-large-and-ptotic-breasts
#5
Danielle H Rochlin, Dung H Nguyen
BACKGROUND: Women with large and/or ptotic breasts are often not considered candidates for nipple-sparing mastectomy (NSM) and/or immediate breast reconstruction given difficulties avoiding ischemic complications and achieving a favorable aesthetic result. We report a novel technique involving deepithelialized skin reduction to simultaneously reduce the skin envelope and preserve perfusion to the skin and nipple in immediate breast reconstruction for women that fit this high-risk anatomic profile...
April 30, 2018: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29746274/combined-autologous-and-prosthetic-breast-reconstruction-defining-the-upper-limits-of-safe-expansion-in-obesity
#6
Joshua H Choo, Thomas J Lee, Steven A Schulz, Mitchell Buller, Bradon J Wilhelmi
BACKGROUND: Combined latissimus dorsi and prosthetic reconstruction is a useful reconstructive option in patients with a history of breast radiation who are not good candidates for abdominally based autologous reconstruction. One difficulty, particularly in obese patients, is that the thickness of the flap can impair port localization, increasing the risk of inadvertent puncture during expansion. The authors sought to investigate the upper limits of tissue thickness at which tissue expansion can be reliably performed...
April 30, 2018: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29741462/complications-risk-factors-and-patients-reported-outcomes-after-skin-sparing-mastectomy-followed-by-breast-reconstruction-in-women-with-brca-mutations
#7
Ingvild O Moberg, Inger Schou Bredal, Michael R Schneider, Kim A Tønseth, Ellen Schlichting
BACKGROUND: Women with a BRCA mutation have the option of undergoing prophylactic mastectomy and immediate breast reconstruction; however, the potential negative effects of reconstruction on women's physical and psychological well-being are unclear. This study aimed to investigate complications, patient-reported pain, health-related quality-of-life (HRQoL) and satisfaction following reconstructive surgery at Oslo University Hospital between 2006 and 2013. METHODS: Data were collected retrospectively from the records of 238 patients...
May 9, 2018: Journal of Plastic Surgery and Hand Surgery
https://www.readbyqxmd.com/read/29719439/factors-affecting-radiotherapy-prescribing-patterns-in-the-post-mastectomy-setting
#8
T A Koulis, A Dang, C Speers, R A Olson
Background: Radiation therapy (rt) after mastectomy for breast cancer can improve survival outcomes, but has been associated with inferior cosmesis after breast reconstruction. In the literature, rt dose and fractionation schedules are inconsistently reported. We sought to determine the pattern of rt prescribing practices in a provincial rt program for patients treated with mastectomy and reconstruction. Methods: Women diagnosed with stages 0-iii breast cancer between January 2012 and December 2013 and treated with curative-intent rt were identified from a clinicopathology database...
April 2018: Current Oncology
https://www.readbyqxmd.com/read/29697604/facebook-facts-breast-reconstruction-patient-reported-outcomes-using-social-media
#9
Sherry Y Q Tang, Jacqueline S Israel, Samuel O Poore, Ahmed M Afifi
BACKGROUND: Social media are used for information sharing among patients with similar health conditions, and analysis of social media activity could inform clinical decision-making. The aim of this study was to use Facebook to evaluate a cohort of individuals' perceptions of and satisfaction with breast reconstruction. METHODS: In this observational study, the authors collected and analyzed posts pertaining to autologous and implant-based breast reconstruction from active Facebook groups...
May 2018: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/29697603/validated-outcomes-in-the-grafting-of-autologous-fat-to-the-breast-the-vogue-study-development-of-a-core-outcome-set-for-research-and-audit
#10
Riaz A Agha, Thomas E Pidgeon, Mimi R Borrelli, Naeem Dowlut, Ter-Er K Orkar, Maziyah Ahmed, Ojas Pujji, Dennis P Orgill
BACKGROUND: Autologous fat grafting is an important part of the reconstructive surgeon's toolbox when treating women affected by breast cancer and subsequent tumor extirpation. The debate over safety and efficacy of autologous fat grafting continues within the literature. However, work performed by the authors' group has shown significant heterogeneity in outcome reporting. Core outcome sets have been shown to reduce heterogeneity in outcome reporting. The authors' goal was to develop a core outcome set for autologous fat grafting in breast reconstruction...
May 2018: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/29684623/decoration-of-rgd-mimetic-porous-scaffolds-with-engineered-and-devitalized-extracellular-matrix-for-adipose-tissue-regeneration
#11
Eleonora Rossi, Julien Guerrero, Paola Aprile, Alessandro Tocchio, Elisabeth A Kappos, Cristina Lenardi, Ivan Martin, Arnaud Scherberich
Fat grafting is emerging as a promising alternative to silicon implants in breast reconstruction surgery. Unfortunately, this approach does not provide a proper mechanical support and is affected by drawbacks such as tissue resorption and donor site morbidity. Synthetic scaffolds can offer a valuable alternative to address these challenges, but poorly recapitulate the biochemical stimuli needed for tissue regeneration. Here, we aim at combining the positive features of a structural, synthetic polymer to an engineered, devitalized extracellular matrix (ECM) to generate a hybrid construct that can provide a mix of structural and biological stimuli needed for adipose tissue regeneration...
April 20, 2018: Acta Biomaterialia
https://www.readbyqxmd.com/read/29678302/patient-reported-outcome-measures-in-breast-cancer-patients
#12
M Lagendijk, L S E van Egdom, C Richel, N van Leeuwen, C Verhoef, H F Lingsma, L B Koppert
INTRODUCTION: In the International Consortium for Health Outcome Measures (ICHOM) breast cancer outcome set Patient Reported Outcome Measurements (PROMs) form an important but rather innovative part. Few data exist on scores per type of breast surgery and how to use scores in surgical practice. We evaluated PROM scores as well as satisfaction with and expectations of the use of PROMs in breast cancer patients using the national and local patient advocate society. METHODS: Through an online survey patients were asked to report age, type of breast cancer surgery (whether Breast Conserving Therapy (BCT), mastectomy, autologous or implant breast reconstruction) and time since surgery...
March 21, 2018: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/29672777/diep-flap-breast-reconstruction-complication-rate-in-previously-irradiated-internal-mammary-nodes
#13
Shirley Shechter, Ehud Arad, Amir Inbal, Or Friedman, Eyal Gur, Yoav Barnea
BACKGROUND:  Postmastectomy radiation therapy (PMRT) is a widely accepted treatment for locally advanced breast cancer. Some patients require additional boost radiation to the internal mammary nodes as the part of regional nodal irradiation (RNI). Delayed breast reconstruction with an autologous free flap using the internal mammary vessels for microvascular flap anastomosis is a common practice for these patients. The aim of our study was to evaluate the effect of RNI on autologous microvascular breast reconstruction...
April 19, 2018: Journal of Reconstructive Microsurgery
https://www.readbyqxmd.com/read/29666911/dual-coverage-of-the-inferior-pole-with-conjoined-fascial-flap-and-acellular-dermal-matrix-for-immediate-one-stage-breast-reconstruction-with-a-prosthetic-implant
#14
Seo H Lee, Yong S Chun, Heung K Park, Yang W Kim, Young W Cheon
BACKGROUND: Elevation of a conjoined fascial flap composed of the pectoralis major, serratus anterior, and external oblique fascia is a type of surgical technique using autologous tissue to cover the lower pole after immediate one-stage direct-to-implant (DTI) breast reconstruction. However, volumetric breast implants hinder use of this technique alone. For better structural stability and more aesthetically favorable breast contour in large breasts, we have devised a technique involving dual coverage of the lower pole by a conjoined fascial flap and acellular dermal matrix (ADM)...
April 17, 2018: Aesthetic Plastic Surgery
https://www.readbyqxmd.com/read/29665804/immediate-implant-replacement-with-diep-flap-a-single-stage-salvage-option-in-failed-implant-based-breast-reconstruction
#15
Miguel De La Parra Marquez, Ricardo Fernandez-Riera, Hector Vela Cardona, Jesus María Rangel Flores
BACKGROUND: Implant-based immediate breast reconstruction after skin-sparing mastectomy has shown a significant improvement in patients' quality of life, making the procedure steadily more popular year after year. However, this technique has a high morbidity rate, including skin necrosis and implant exposure. METHODS: A retrospective review of a prospectively held database for autologous breast reconstruction in our institution of the last 5 years found eight cases with exposed implants after nipple-sparing mastectomy and immediate reconstruction...
April 17, 2018: World Journal of Surgical Oncology
https://www.readbyqxmd.com/read/29660760/racial-disparities-in-postmastectomy-breast-reconstruction-national-trends-in-utilization-from-2005-to-2014
#16
Sherise Epstein, Bao N Tran, Justin B Cohen, Samuel J Lin, Dhruv Singhal, Bernard T Lee
BACKGROUND: Evidence of racial disparities in the receipt of postmastectomy breast reconstruction is well documented. The objective of this study was to describe trends in racial disparities overall and by reconstructive technique. METHODS: The American College of Surgeons National Surgical Quality Improvement Program database was used to identify women who underwent mastectomy and/or breast reconstruction from 2005 to 2014. Patient demographics were recorded, and cases were grouped by reconstructive status and technique...
April 16, 2018: Cancer
https://www.readbyqxmd.com/read/29659449/evolution-in-monitoring-of-free-flap-autologous-breast-reconstruction-after-nipple-sparing-mastectomy-is-there-a-best-way
#17
Jordan D Frey, John T Stranix, Michael V Chiodo, Michael Alperovich, Christina Y Ahn, Robert J Allen, Mihye Choi, Nolan S Karp, Jamie P Levine
BACKGROUND: Free flap monitoring in autologous reconstruction after nipple-sparing mastectomy remains controversial. The authors therefore examined outcomes in nipple-sparing mastectomy with buried free flap reconstruction versus free flap reconstruction incorporating a monitoring skin paddle. METHODS: Autologous free flap reconstructions with nipple-sparing mastectomy performed from 2006 to 2015 were identified. Demographics and operative results were analyzed and compared between buried flaps and those with a skin paddle for monitoring...
May 2018: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/29653454/how-does-autologous-breast-reconstruction-impact-downtime
#18
Giovanni Zoccali, Daniel Simon Rais, Jian Farhadi
BACKGROUND:  Although autologous breast reconstruction is technically quite demanding, it offers the best outcomes in terms of durable results, patient perceptions, and postoperative pain. Many studies have focused on clinical outcomes and technical aspects of such procedures, but few have addressed the impact of various flaps on patient recovery times. This particular investigation entailed an assessment of commonly used flaps, examining the periods of time required to resume daily activities...
April 13, 2018: Journal of Reconstructive Microsurgery
https://www.readbyqxmd.com/read/29651851/patient-satisfaction-after-breast-reconstruction-implants-vs-autologous-tissues
#19
S Fracon, N Renzi, M Manara, V Ramella, G Papa, Z M Arnež
INTRODUCTION: Breast reconstruction is increasingly present in the treatment of breast cancer. It may be accomplished with implants or autologous tissues. This cross-sectional study evaluates patients satisfaction and quality of life in women after successful autologous or implant breast reconstruction. MATERIAL AND METHODS: 109 women who successfully underwent breast reconstruction between 2007 and 2016 were included. The patients completed the BREAST-Q questionnaire at follow-up visits...
2018: Acta Chirurgiae Plasticae
https://www.readbyqxmd.com/read/29620551/practical-applications-of-delayed-immediate-autologous-breast-reconstruction-a-flexible-and-safe-operative-strategy
#20
Gloria R Sue, Arhana Chattopadhyay, Chao Long, Eva A Huis in 't Veld, Gordon K Lee
BACKGROUND: Timing is an important consideration in patients undergoing mastectomy for breast cancer. While immediate reconstruction results in superior aesthetic outcomes, the need for postmastectomy radiation can often only be ascertained after review of surgical pathology. Delayed-immediate autologous reconstruction (DIAR) is a reconstructive approach that consists of mastectomy with tissue expander placement in the first stage and flap-based breast reconstruction in the second stage...
May 2018: Annals of Plastic Surgery
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