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https://www.readbyqxmd.com/read/28079533/national-and-regional-differences-in-32-248-postmastectomy-autologous-breast-reconstruction-using-the-updated-national-inpatient-survey
#1
Parisa Kamali, Marek A Paul, Ahmed M S Ibrahim, Pieter G L Koolen, Winona Wu, Marc L Schermerhorn, Bernard T Lee, Samuel J Lin
BACKGROUND: The incidence of breast cancer (BC) cases has increased significantly. The number of breast reconstruction (BR) procedures performed has mirrored this trend. Although implant-only procedures remain the most commonly used type of immediate BR, autologous techniques involving donor sites account for approximately 20%. The aim of this study was to assess national and regional trends in different types of autologous BR. METHODS: Using the Nationwide Inpatient Sample database (2008 to 2012), data on BC and mastectomy rates, type of autologous BR, and sociodemographics were obtained and analyzed...
January 10, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28052051/deep-inferior-epigastric-perforator-versus-free-transverse-rectus-abdominis-myocutaneous-flap-complications-and-resource-utilization
#2
Yasmina Zoghbi, David J Gerth, Jun Tashiro, Samuel Golpanian, Seth R Thaller
INTRODUCTION: Abdominal based breast reconstruction exists in a continuum from pedicled transverse rectus abdominis myocutaneous (TRAM) flap to deep inferior epigastric perforator (DIEP) free flap. DIEP flap has the advantage of complete rectus abdominis sparing during harvest, thus decreasing donor site morbidity. Aim of this study is to determine whether the surgical advantages of the DIEP flap impact postoperative outcomes versus the free TRAM flap (fTRAM). METHODS: We reviewed the Nationwide Inpatient Sample database (2010-2011) for all cases of DIEP and fTRAM breast reconstruction...
November 3, 2016: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28035905/a-rare-case-of-umbilical-metastasis-after-delayed-transverse-rectus-abdominis-myocutaneous-flap-reconstruction-for-invasive-breast-cancer
#3
Nicky Claire Seymour, Rathi Rathinaezhil
A 46-year-old female presented with an inflamed and painful umbilicus. Past medical history included breast cancer, followed by metastatic sternal cancer two years after the initial breast cancer diagnosis.The painful umbilicus was confirmed metastasis from a primary breast cancer she had treated eleven years previously.Metastases to the umbilicus are rare, and are usually gastrointestinal in origin. To our knowledge this is the first report of a metastasis from any primary cancer to the umbilicus after transverse rectus abdominis myocutaneous flap (TRAM)...
December 29, 2016: Breast Disease
https://www.readbyqxmd.com/read/28032178/comparison-of-aesthetic-outcomes-between-vertical-and-horizontal-flap-insets-in-breast-reconstruction-with-the-tram-or-diep-flaps
#4
Woo Shik Jeong, Wooyeon Han, Jin Sup Eom
BACKGROUND: Tissue transfer, such as use of the transverse rectus abdominis myocutaneous (TRAM) or deep inferior epigastric artery perforator (DIEP) free flaps, is considered a standard method. However, outcomes may vary among inset methods. Here we compared the aesthetic outcomes of breast reconstructions using vertical and horizontal flap inset methods. METHODS: We, respectively, reviewed 274 patients who underwent unilateral post-mastectomy breast reconstruction using TRAM or DIEP free flaps between April 2006 and December 2013...
December 28, 2016: Aesthetic Plastic Surgery
https://www.readbyqxmd.com/read/27988412/breast-reconstruction-after-mastectomy-a-ten-year-analysis-of-trends-and-immediate-postoperative-outcomes
#5
Nicole Ilonzo, Ashley Tsang, Sara Tsantes, Alison Estabrook, Aye Moe Thu Ma
: The landscape of breast reconstruction has changed significantly. This study assesses trends in type of reconstruction performed after mastectomy and impact on immediate postoperative complications. METHODS: Data for 67,450 patients undergoing mastectomy for breast cancer were analyzed using the National Surgical Quality Improvement Program (NSQIP) database for years 2005-2014. Primary outcomes were wound, nonwound related infections, and bleeding complications...
December 15, 2016: Breast: Official Journal of the European Society of Mastology
https://www.readbyqxmd.com/read/27913969/laser-photobiomodulation-830-and-660%C3%A2-nm-in-mast-cells-vegf-fgf-and-cd34-of-the-musculocutaneous-flap-in-rats-submitted-to-nicotine
#6
Lais Mara Siqueira das Neves, Gabriella de Paula Marcondes Ferreira Leite, Alexandre Marcio Marcolino, Carlos Eduardo Pinfildi, Sérgio Britto Garcia, João Eduardo de Araújo, Elaine Caldeira de Oliveira Guirro
The aim of this study was to investigate the effect of laser photobiomodulation (PBM) on the viability of the transverse rectus abdominis musculocutaneous (TRAM) flap in rats subjected to the action of nicotine. We evaluated 60 albino Wistar rats, divided into six groups of ten animals. Group 1 (saline) underwent the surgical technique to obtain a TRAM flap; group 2 (laser 830 nm) underwent the surgical technique and was irradiated with a laser 830 nm; group 3 (laser 660 nm) underwent the surgical technique and was irradiated with a laser 660 nm; group 4 was treated with nicotine subcutaneously (2 mg/kg/2×/day/4 weeks) and underwent surgery; group 5 (nicotine + laser 830 nm) was exposed to nicotine, underwent the surgical technique, and was irradiated with a laser 830 nm; group 6 (nicotine + laser 660 nm) was exposed to nicotine, underwent the surgical technique, and was irradiated with a laser 660 nm...
December 2, 2016: Lasers in Medical Science
https://www.readbyqxmd.com/read/27798949/impact-of-time-interval-between-radiation-and-free-autologous-breast-reconstruction
#7
Aaron B Mull, Ali A Qureshi, Ema Zubovic, Yuan J Rao, Imran Zoberi, Ketan Sharma, Terence M Myckatyn
BACKGROUND: To evaluate whether the timing of surgery after radiation in autologous breast reconstruction affects major complications. METHODS: We performed a retrospective review of 454 free flaps (331 patients) for breast reconstruction at a single institution from 2003 to 2014. Charts were reviewed for age, BMI, laterality, flap type (TRAM, msTRAM, DIEP), surgeon, donor vessels (IMA, TD), chemotherapy, smoking, diabetes, hypertension, DVT, venous anastomoses, vein size, and time from radiation (none, < 12 months, or ≥ 12 months)...
October 31, 2016: Journal of Reconstructive Microsurgery
https://www.readbyqxmd.com/read/27785362/low-intensity-pulsed-ultrasound-stimulation-in-different-regions-in-the-viability-of-myocutaneous-flaps
#8
Fernanda Luiza de Almeida Albuquerque, Lais Mara Siqueira das Neves, Elaine Caldeira de Oliveira Guirro
BACKGROUND: Low-intensity pulsed ultrasound (LIPUS) has presented good results in the healing of chronic wounds. The objective of this study was to compare the effect of LIPUS on the viability of transverse rectus abdominal muscle (TRAM) flap in different regions (central and epigastric) in rats. METHODS: Twenty-one Wistar male rats were homogeneously distributed into three groups as follows: group 1 (control), animals submitted to surgery only; group 2, animals submitted to surgery and application of LIPUS at the center of the flap; and group 3, animals submitted to surgery and application of LIPUS at the flap area corresponding to the right inferior epigastric artery pedicle...
2016: Journal of Therapeutic Ultrasound
https://www.readbyqxmd.com/read/27757337/abdominal-closure-after-tram-flap-breast-reconstruction-with-transversus-abdominis-muscle-release-and-mesh
#9
Antonio Espinosa-de-Los-Monteros, Héctor Avendano-Peza, Yuri W Novitsky
Breast reconstruction with a pedicled transverse rectus abdominis muscle (TRAM) flap can result in significant abdominal wall donor-site morbidity. Although the pedicled TRAM flap donor area reinforced with mesh results in decreased rates of postoperative abdominal bulging and hernias, the best technique to accomplish that is yet to be elucidated. We present our novel technique of posterior components separation with transversus abdominis muscle release and retromuscular mesh reinforcement for donor-area closure during pedicled TRAM flap breast reconstruction...
September 2016: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/27743083/free-versus-pedicled-tram-flaps-cost-utilization-and-complications
#10
Samuel Golpanian, David J Gerth, Jun Tashiro, Seth R Thaller
INTRODUCTION: Conventionally, free transverse rectus abdominis myocutaneous (fTRAM) flap breast reconstruction has been associated with decreased donor site morbidity and improved flap inset. However, clinical success depends upon more sophisticated technical expertise and facilities. This study aims to characterize postoperative outcomes undergoing free versus pedicled TRAM (pTRAM) flap breast reconstruction. METHODS: Nationwide inpatient sample database (2008-2011) was reviewed for cases of fTRAM (ICD-9-CM 85...
December 2016: Aesthetic Plastic Surgery
https://www.readbyqxmd.com/read/27707079/the-protective-effect-of-cilostazol-on-transverse-rectus-abdominis-myocutaneous-flap-in-rats
#11
Ayfer Özdemir, Erkan Orhan, Serdar Altun, Emre İnözü
OBJECTIVE: Transverse Rectus Abdominis Myocutaneous (TRAM) flap is commonly used in breast reconstruction. The aim of this study is to demonstrate the effects of cilostazol on TRAM flap viability in a rat TRAM model. METHODS: Twenty-four Wistar rats were used. They were divided into four groups. Rats in Group 1 were applied TRAM flap. In Group 2, cilostazol 30 mg/kg was administered to rats via oral gavage 3 hours before the flap surgery. After the flap surgery, cilostazol 30 mg/kg was administered via oral gavage twice a day for 7 days...
October 6, 2016: Journal of Plastic Surgery and Hand Surgery
https://www.readbyqxmd.com/read/27689049/acellular-dermal-matrix-as-a-core-strut-for-projection-in-nipple-reconstruction-approaches-for-three-different-methods-of-breast-reconstruction
#12
Gui-Yong Park, Eul-Sik Yoon, Hee-Eun Cho, Byung-Il Lee, Seung-Ha Park
BACKGROUND: The objective of this paper was to describe a novel technique for improving the maintenance of nipple projection in primary nipple reconstruction by using acellular dermal matrix as a strut in one of three different configurations, according to the method of prior breast reconstruction. The struts were designed to best fill the different types of dead spaces in nipple reconstruction depending on the breast reconstruction method. METHODS: A total of 50 primary nipple reconstructions were performed between May 2012 and May 2015...
September 2016: Archives of Plastic Surgery
https://www.readbyqxmd.com/read/27611237/immediate-expander-implant-breast-reconstruction-followed-by-post-mastectomy-radiotherapy-for-breast-cancer-aesthetic-surgical-satisfaction-and-quality-of-life-outcomes-in-women-with-high-risk-breast-cancer
#13
Meagan E Brennan, Kathy Flitcroft, Sanjay Warrier, Kylie Snook, Andrew J Spillane
BACKGROUND: Immediate tissue expander/implant-based breast reconstruction (BR) is often avoided when post-mastectomy radiotherapy (PMRT) is planned due to concerns about high complication rates and poor aesthetic outcomes. This study evaluated surgical, aesthetic and quality of life (QoL) outcomes in women undergoing immediate implant-based BR (IIBR) followed by PMRT. METHODS: Participants were recruited at least six months after completing the final stage of BR...
December 2016: Breast: Official Journal of the European Society of Mastology
https://www.readbyqxmd.com/read/27582412/is-immediate-reconstruction-after-mastectomy-in-breast-cancer-patients-beneficial-to-shoulder-function
#14
Bong Gun Lee, Joon Kuk Kim, Sung Hyouk Choi, Hee Chang Ahn, Min Sung Chung
BACKGROUND: To compare shoulder morbidity between patients who received transverse rectus abdominis myocutaneous (TRAM) flaps after mastectomy (MX + TRAM) and patients who underwent mastectomy only (MX). METHODS: Thirty patients in each group were followed for a minimum of 2 postoperative years. Visual analog scale (VAS) score, restricted range of motion (ROM), rotator cuff disease, muscle strength, shoulder function scores (American Shoulder and Elbow Score and Shoulder Pain and Disability Index), measurement of scapular tilt on chest radiography and standing position in each group were compared...
August 31, 2016: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/27563562/complications-and-oncologic-outcomes-of-pedicled-transverse-rectus-abdominis-myocutaneous-flap-in-breast-cancer-patients
#15
Prakasit Chirappapha, Ongart Somintara, Panuwat Lertsithichai, Youwanush Kongdan, Chairat Supsamutchai, Rupporn Sukpanich
BACKGROUND: There are several techniques for harvesting the pedicled transverse rectus abdominis myocutaneous (TRAM) flap after mastectomy in breast cancer patients. We examined the whole muscle with partial sheath sparing technique and determined factors associated with its complications and oncological outcomes. METHODS: We retrospectively reviewed the results of 168 TRAM flaps performed between January 2003 and December 2010, focusing on complications and oncologic outcomes...
August 2016: Gland Surgery
https://www.readbyqxmd.com/read/27537823/chylous-ascites-after-pedicled-transverse-rectus-abdominis-myocutaneous-flap-harvest
#16
Chin-Ta Lin, Tim-Mo Chen
Chylous ascites is a rare clinical condition that occurs as a consequence of disruption of the abdominal lymphatics. Here, we present the case of a 58-year-old woman with sustained chylous ascites after pedicled transverse rectus abdominis myocutaneous (TRAM) flap harvest. The chylous ascites did not decrease despite conservative therapy. For the diagnosis and localization of the chyle leakage, lymphangiography with lipiodol delivery was performed. Chylous drainage continued in a decreasing manner for the next 4 d because lipiodol accumulated to the point of leakage outside the lymphatic vessel causing a regional inflammatory reaction and obstructing the lymphatic vessels...
August 2016: Acta Chirurgica Belgica
https://www.readbyqxmd.com/read/27522453/cracking-the-perfusion-code-laser-assisted-indocyanine-green-angiography-and-combined-laser-doppler-spectrophotometry-for-intraoperative-evaluation-of-tissue-perfusion-in-autologous-breast-reconstruction-with-diep-or-ms-tram-flaps
#17
Ingo Ludolph, Andreas Arkudas, Marweh Schmitz, Anja M Boos, Christian D Taeger, Ulrich Rother, Raymund E Horch, Justus P Beier
The aim of this prospective study was to assess the correlation of flap perfusion analysis based on laser-assisted Indocyanine Green (ICG) angiography with combined laser Doppler spectrophotometry in autologous breast reconstruction using free DIEP/ms-TRAM flaps. Between February 2014 and July 2015, 35 free DIEP/ms-TRAM flaps were included in this study. Besides the clinical evaluation of flaps, intraoperative perfusion dynamics were assessed by means of laser-assisted ICG angiography and post-capillary oxygen saturation and relative haemoglobin content (rHb) using combined laser Doppler spectrophotometry...
October 2016: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/27406872/breast-reconstruction-with-single-pedicle-tram-flap-in-breast-cancer-patients-with-low-midline-abdominal-scar
#18
Jun-Dong Wu, Wen-He Huang, Si-Qi Qiu, Li-Fang He, Cui-Ping Guo, Yong-Qu Zhang, Fan Zhang, Guo-Jun Zhang
Breast reconstruction with transverse rectus abdominis myocutaneous (TRAM) flap is challenging in patients with low midline abdominal scar. In this study, we aimed to investigate the clinical feasibility of immediate breast reconstruction using single-pedicle TRAM (SP-TRAM) flaps in patients with low midline abdominal scar. There were 4 strict selection criteria: 1) presence at least 3 perforators on the pedicle side; 2) perforators with regional average flow velocity of >20 cm/s; 3) upper edge of the abdominal scar at least 4 cm from the umbilicus; and 4) scar age >1 year...
2016: Scientific Reports
https://www.readbyqxmd.com/read/27121604/risk-factors-of-mastectomy-skin-flap-necrosis-in-immediate-breast-reconstruction-using-low-abdominal-flaps
#19
Taik Jong Lee, Tae Suk Oh, Eun Key Kim, Hyunsuk Suh, Sei Hyun Ahn, Byung Ho Son, Jong Won Lee, Jonghan Cho, Jin Sup Eom
BACKGROUND: The purpose of this study was to determine the risk factors associated with mastectomy skin flap necrosis during immediate reconstruction with TRAM or DIEP flaps. METHODS: This study reviewed 1116 cases of immediate breast reconstruction over 10 years. Patients ranged in age from 29-76 years (average = 45.1 years), and had an average follow-up period of 65.6 months. Thirteen factors (age, BMI (body mass index), smoking habits, diabetes ptosis grade, midclavicle-to-nipple distance, neoadjuvant chemotherapy, free or pedicled flap, mastectomy method, surgeon, stage, axillary dissection, mastectomy weight) known to be associated with mastectomy flap necrosis were retrospectively analysed...
October 2016: Journal of Plastic Surgery and Hand Surgery
https://www.readbyqxmd.com/read/27119911/dual-pedicle-flap-for-unilateral-autologous-breast-reconstruction-revisited-evolution-and-optimization-of-flap-design-over-15-years
#20
Edward I Chang, Steven J Kronowitz
BACKGROUND: In thin patients or when a significant amount of skin is needed, use of the entire abdomen to reconstruct a single breast may be necessary. In this article, the authors present their 15-year experience in dual-pedicle flap evolution and optimization of flap design. METHODS: A retrospective review was conducted of all bipedicle flaps performed from 2000 to 2015. RESULTS: Overall, 57 patients (mean age, 49.2 years; mean body mass index, 26...
May 2016: Plastic and Reconstructive Surgery
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