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Zheng S, Hao S, Chen J, Zhang Y, Yang B, Huang X, Liu G, Shao Z, Wu J. Latissimus dorsi flap - the main force in breast reconstruction for breast tumor in Chinese population. Front Oncol 2023; 13:1159073. [PMID: 37546409 PMCID: PMC10400316 DOI: 10.3389/fonc.2023.1159073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 07/06/2023] [Indexed: 08/08/2023] Open
Abstract
Background The latissimus dorsi flap (LDF) is the most commonly used autologous flap for breast reconstruction (BR) in China. We conducted this study to explore the current status of BR using LDF with/without implants. Methods This study was a single-center retrospective study that included breast tumor patients who underwent LDF breast reconstruction at Fudan University Shanghai Cancer Center (FUSCC) between 2000 and 2021. Results We analyzed 4918 patients who underwent postmastectomy BR, including 1730 patients (35.2%) with autologous flaps. LDF was used for BR in 1093 (22.2%) patients, and an abdominal flap was used in 637 (13.0%) patients. The proportion of LDFs used in autologous BR patients decreased each year and dropped to approximately 65.0% after 2013 due to the increased use of abdominal flaps. Among these patients, 609 underwent extended LDF (ELDF) BR, 455 underwent LDF BR with implants, and 30 received a LDF as a salvage flap due to previous flap or implant failure. Patients who underwent ELDF reconstruction were older and had a higher BMI than those who received a LDF with implants. There was no significant difference in the mean postoperative hospital stay, neoadjuvant chemotherapy rates, or adjuvant radiotherapy rates between the two groups. Major complications requiring surgical intervention occurred in 25 patients (2.29%). There was no significant difference in the incidence of major complications between the two groups (P=0.542). Conclusions LDF breast reconstruction is a well-developed and safe procedure. The duration of postoperative hospitalization nor the incidence of major complications was affected by implant use.
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Affiliation(s)
- Shuyue Zheng
- Department of Breast Surgery, Fudan University Shanghai Cancer Center, Shanghai, China
- Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai, China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Shuang Hao
- Department of Breast Surgery, Fudan University Shanghai Cancer Center, Shanghai, China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Jiajian Chen
- Department of Breast Surgery, Fudan University Shanghai Cancer Center, Shanghai, China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Yingying Zhang
- Department of Breast Surgery, Fudan University Shanghai Cancer Center, Shanghai, China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Benlong Yang
- Department of Breast Surgery, Fudan University Shanghai Cancer Center, Shanghai, China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Xiaoyan Huang
- Department of Breast Surgery, Fudan University Shanghai Cancer Center, Shanghai, China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Guangyu Liu
- Department of Breast Surgery, Fudan University Shanghai Cancer Center, Shanghai, China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Zhimin Shao
- Department of Breast Surgery, Fudan University Shanghai Cancer Center, Shanghai, China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Jiong Wu
- Department of Breast Surgery, Fudan University Shanghai Cancer Center, Shanghai, China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
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Beauty Is in the Eye of the Beholder: Factors Influencing Disparity in Perceptions of Breast Reconstruction Aesthetic Outcomes. Plast Reconstr Surg 2022; 150:42e-50e. [PMID: 35499515 DOI: 10.1097/prs.0000000000009254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Patient-reported outcomes are the primary measurement of breast reconstruction success, but results may be affected by nontechnical factors such as socioemotional determinants. Third-party observers provide an independent assessment of aesthetic outcomes. Factors associated with disparity between patient and observer perceptions of outcomes are not well understood. METHODS One hundred forty-seven patients underwent breast reconstruction at the authors' institution between 2009 and 2011, completed the BREAST-Q, and had photographs graded by a diverse panel using the Validated Breast Aesthetic Scale. Patient satisfaction with breasts scores that aligned with observer scores were categorized as group 2; patient satisfaction that exceeded observer scores were group 1; and those lower than observer scores were group 3. Statistical analysis was performed using SPSS, with values of p < 0.05 considered statistically significant. RESULTS Twenty-eight patients (19 percent) were categorized as group 1, 93 (63 percent) in group 2, and 26 (18 percent) in group 3. Median overall appearance was highest in group 3 (median, 4.0; interquartile range, 4 to 4) and lowest in group 1 (median, 3.0; interquartile range, 2 to 3) ( p < 0.001). Psychosocial, sexual, and physical well-being were significantly associated with disparity (group 1 or 3 status) ( p < 0.01). Satisfaction with outcomes, nipples, abdomen, and breasts were significantly associated with disparity. Factors not significantly associated with disparity include age, body mass index, autologous or implant-based, adjuvant therapies, and timing of reconstruction. CONCLUSIONS Incongruously high patient satisfaction with breast reconstruction aesthetics relative to third-party perception of aesthetic outcomes is associated with high quality-of-life scores. Incongruously low patient satisfaction with breast cosmesis compared with higher third-party perceptions was associated with low quality-of-life scores. CLINICAL QUESTION/LEVEL OF EVIDENCE Risk, II.
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Xing J, Jia Z, Xu Y, Chen M, Chen Y, Han Y. A Bayesian Network Meta-Analysis of Complications Related to Breast Reconstruction Using Different Skin Flaps After Breast Cancer Surgery. Aesthetic Plast Surg 2022; 46:1525-1541. [PMID: 35257200 DOI: 10.1007/s00266-022-02828-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Accepted: 02/08/2022] [Indexed: 12/01/2022]
Abstract
BACKGROUND AND OBJECTIVES As the incidence of breast cancer rises, the number of mastectomy surgeries surges, so does the importance of postoperative breast reconstruction. The implementation of autologous flap restoration methods is becoming prevalent, although which is the best flap remains controversial. As a result, we performed a Bayesian network meta-analysis to compare the eight most common flap in the reconstruction processor of breast cancer surgery. Our findings may help surgeons decide which skin flaps to use for breast reconstruction. METHODS We searched PubMed, Medline, Embase, and the Cochrane library for relevant literature. For our Bayesian network meta-analysis, we scrutinized 37 papers and evaluated the postoperative complications of eight commonly used breast reconstruction procedures. We also registered this study on PROSPERO, with the number CRD42021251989. RESULTS A total of 21,184 patients were included in this Bayesian network meta-analysis from 37 different studies. The results demonstrate that TRAM flaps are more prone to complications such as hernias in the abdominal wall and blood flow problems. Hematoma and seroma are more likely to follow LDP flaps. Combining LDP flaps with a prosthetic or autologous adipose tissue does not enhance the risk of postoperative problems appreciably. Fat liquefaction are relatively common in DIEP. CONCLUSIONS After breast reconstruction, several skin flaps can be employed as clinical choices. TRAM flaps are not recommended for patients with a weak abdominal wall structure, although LDP flaps or SIEA flaps can be considered instead. We do not advocate LDP flaps for patients who have had breast surgery because of the higher risk of hematoma or seroma, but DIEP flaps or LAP flaps can be utilized instead. We do not propose DIEP flaps for individuals who are at a higher risk of postoperative fat liquefaction, but LDP flaps or SIEA flaps can be used instead. However, this Bayesian network meta-analysis has limitations, and further randomized controlled trials are needed to confirm its findings. LEVEL OF EVIDENCE III This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Affiliation(s)
- Jiahua Xing
- School of Medicine, Nankai University, Tianjin, 300071, China
- Department of Plastic and Reconstructive Surgery, The First Medical Center, Chinese PLA General Hospital, 28 Fuxing Street, Beijing, 100853, China
| | - Ziqi Jia
- Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, 100730, China
| | - Yichi Xu
- Department of Plastic and Reconstructive Surgery, The First Medical Center, Chinese PLA General Hospital, 28 Fuxing Street, Beijing, 100853, China
| | - Muzi Chen
- School of Medicine, Nankai University, Tianjin, 300071, China
- Department of Plastic and Reconstructive Surgery, The First Medical Center, Chinese PLA General Hospital, 28 Fuxing Street, Beijing, 100853, China
| | - Youbai Chen
- Department of Plastic and Reconstructive Surgery, The First Medical Center, Chinese PLA General Hospital, 28 Fuxing Street, Beijing, 100853, China.
| | - Yan Han
- Department of Plastic and Reconstructive Surgery, The First Medical Center, Chinese PLA General Hospital, 28 Fuxing Street, Beijing, 100853, China.
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Complications and Patient-reported Outcomes after TRAM and DIEP Flaps: A Systematic Review and Meta-analysis. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2020; 8:e3120. [PMID: 33173667 PMCID: PMC7647662 DOI: 10.1097/gox.0000000000003120] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 07/27/2020] [Indexed: 11/30/2022]
Abstract
Supplemental Digital Content is available in the text. Transverse rectus abdominis myocutaneous (TRAM) and deep inferior epigastric artery perforator (DIEP) flaps are the most common abdominally based breast reconstruction procedures. Each technique has its advantages and disadvantages; however, how morbidity relates to satisfaction is not well-understood. Our aim was to compare complications and patient-reported outcomes following pedicled TRAM (pTRAM), free TRAM (fTRAM), and DIEP flaps to guide flap selection.
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Salih AM, Hammood ZD, Kakamad FH, Salih KM, Baba HO, Hassan HA, Mohammed SH, Qadir GA, Hassan HA, Abdullah IY. One for two, ipsilateral reduction and contralateral reconstruction mammoplasty: A case report. Int J Surg Case Rep 2020; 73:58-60. [PMID: 32634619 PMCID: PMC7338683 DOI: 10.1016/j.ijscr.2020.06.075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Revised: 06/14/2020] [Accepted: 06/16/2020] [Indexed: 11/24/2022] Open
Abstract
There is a considerable debate regarding implant or autologous reconstruction of breast. Single session reduction mammoplasty with contralateral autologous reconstruction is feasible. A novel procedure has been presented. Dividing the contralateral breast and creating a myocutaneous flap for reconstruction.
Introduction The aim of this paper is to introduce a novel procedure for concomitant contralateral reduction and ipsilateral reconstruction mammoplasty by dividing the contralateral breast and creating a pectoralis myocutaneous flap for reconstruction. Presentation of case A 34-year-old female, with a history of left side mastectomy presented for reconstruction. Under general anesthesia, the scar of the previous operation was resected in an elliptical shaped incision, the right breast was divided in middle, leaving the flap (pectoralis myocutaneous flap) with pectoralis branch of thoracoacromial artery. The superiomedial part of right breast (the flap) was rotated under the bridge of intermammary skin into the left incision. Ten days after the operation, the flap was viable and healthy. Discussion The aim of breast reconstruction is to provide psychosocial support and improve quality of life in the long term by restoring the shape of the breast surgically. New techniques have emerged constantly, and each comes with its list of advantages and risks. The benefits of reconstruction are clear, yet often it is not found as a part of breast cancer treatment routinely. Conclusion In single session reduction mammoplasty in one breast and using the resected piece as a flap to reconstruct the contralateral breast is possible whenever indication.
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Affiliation(s)
- Abdulwahid M Salih
- Faculty of Medical Sciences, School of Medicine, Department General Surgery, University of Sulaimani, Sulaimani, Kurdistan, Iraq; Smart Health Tower, François Mitterrand Street, Sulaimani, Kurdistan, Iraq
| | - Zuhair D Hammood
- Smart Health Tower, François Mitterrand Street, Sulaimani, Kurdistan, Iraq; Kscien Organization, Hamdi Str, Azadi Mall, Sulaimani, Kurdistan, Iraq
| | - Fahmi H Kakamad
- Faculty of Medical Sciences, School of Medicine, Department General Surgery, University of Sulaimani, Sulaimani, Kurdistan, Iraq; Smart Health Tower, François Mitterrand Street, Sulaimani, Kurdistan, Iraq; Kscien Organization, Hamdi Str, Azadi Mall, Sulaimani, Kurdistan, Iraq.
| | - Karzan M Salih
- Iraqi Board for Medical Specialties, Department of General Surgery, Sulaimani Center, Kurdistan, Iraq
| | - Hiwa O Baba
- Smart Health Tower, François Mitterrand Street, Sulaimani, Kurdistan, Iraq; Kscien Organization, Hamdi Str, Azadi Mall, Sulaimani, Kurdistan, Iraq
| | - Hunar A Hassan
- Smart Health Tower, François Mitterrand Street, Sulaimani, Kurdistan, Iraq; Kscien Organization, Hamdi Str, Azadi Mall, Sulaimani, Kurdistan, Iraq
| | - Shvan H Mohammed
- Kscien Organization, Hamdi Str, Azadi Mall, Sulaimani, Kurdistan, Iraq
| | - Goran A Qadir
- Smart Health Tower, François Mitterrand Street, Sulaimani, Kurdistan, Iraq; Kscien Organization, Hamdi Str, Azadi Mall, Sulaimani, Kurdistan, Iraq; College of Science, Department of Biology, University of Sulaimani, Kurdistan, Iraq
| | - Hemn A Hassan
- Kscien Organization, Hamdi Str, Azadi Mall, Sulaimani, Kurdistan, Iraq
| | - Ismael Y Abdullah
- Kscien Organization, Hamdi Str, Azadi Mall, Sulaimani, Kurdistan, Iraq
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Patient satisfaction with breast reconstruction: how much do timing and surgical technique matter? EUROPEAN JOURNAL OF PLASTIC SURGERY 2020. [DOI: 10.1007/s00238-020-01663-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Matthews H, Carroll N, Renshaw D, Turner A, Park A, Skillman J, McCarthy K, Grunfeld EA. Predictors of satisfaction and quality of life following post-mastectomy breast reconstruction. Psychooncology 2017; 26:1860-1865. [PMID: 28195672 DOI: 10.1002/pon.4397] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2016] [Revised: 02/06/2017] [Accepted: 02/07/2017] [Indexed: 11/10/2022]
Abstract
OBJECTIVE Breast reconstruction is associated with multiple psychological benefits. However, few studies have identified clinical and psychological factors associated with improved satisfaction and quality of life. This study examined factors, which predict satisfaction with breast appearance, outcome satisfaction and quality of life following post-mastectomy breast reconstruction. METHODS Women who underwent post-mastectomy breast reconstruction between 2010 and 2016 received a postal questionnaire consisting of The BREAST-Q Patient Reported Outcomes Instrument, The European Organisation for Research and Treatment of Cancer QLQ-30 Questionnaire, The Patient and Observer Scar Assessment Scale, and a series of Visual-Analogue Scales. One hundredforty-eight women completed the questionnaire, a 56% response rate. RESULTS Hierarchical multiple regression analyses revealed psychosocial factors accounted for 75% of the variance in breast satisfaction, 68% for outcome satisfaction, and 46% forquality of life. Psychosocial well-being emerged as a significant predictor of satisfaction with breast appearance (β = .322) and outcome satisfaction (β = .406). Deep inferior epigastric perforator flap patients reported greater satisfaction with breast appearance (β = .120) and outcome satisfaction (β = .167). CONCLUSIONS This study extends beyond the limited research by distinguishing between satisfaction with breast appearance and outcome satisfaction. The study provides evidence for the role of psychosocial factors predicting key patient reported outcomes and demonstrates the importance of psychosocial well-being and reconstruction type. The findings also highlight the need for healthcare providers to consider the psychosocial well-being of patients both preoperatively and post operatively and provide preliminary evidence for the use of deep inferior epigastric perforator reconstructions over other types of reconstructive procedures.
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Affiliation(s)
- Hannah Matthews
- Centre for Technology Enabled Health Research, Faculty of Health and Life Sciences, Coventry University, Coventry, UK
| | | | - Derek Renshaw
- Centre for Applied Biological and Exercise Sciences, Faculty of Health and Life Sciences, Coventry University, Coventry, UK
| | - Andrew Turner
- Centre for Technology Enabled Health Research, Faculty of Health and Life Sciences, Coventry University, Coventry, UK
| | - Alan Park
- University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK
| | - Jo Skillman
- University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK
| | - Kate McCarthy
- University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK
| | - Elizabeth A Grunfeld
- Centre for Technology Enabled Health Research, Faculty of Health and Life Sciences, Coventry University, Coventry, UK
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Duraes EFR, Durand P, Duraes LC, Orra S, Moreira-Gonzalez A, Sousa JBD, Djohan RS, Zins J, Bernard S, Schwarz GS. Comparison of preoperative quality of life in breast reconstruction, breast aesthetic and non-breast plastic surgery patients: A cross-sectional study. J Plast Reconstr Aesthet Surg 2016; 69:1478-1485. [PMID: 27650121 DOI: 10.1016/j.bjps.2016.08.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2015] [Revised: 03/11/2016] [Accepted: 08/22/2016] [Indexed: 11/25/2022]
Abstract
A breast cancer diagnosis imposes significant emotional and psychological duress. The purpose of this study is to assess the baseline quality of life (QOL) of immediate, delayed, and secondary breast reconstruction patients, comparing these results with QOL in women seeking plastic surgery for cosmetic breast, and non-breast procedures. From 2012 through 2013, immediate (group 1), delayed (group 2), and secondary (Group 3) reconstruction patients, aesthetic breast (group 4) and non-breast plastic surgery patients (group 5) answered Breast-Q questionnaires. Groups 1, 2, 3, 4, and 5 answered 141, 12, 23, 72 and 160 preoperative questionnaires respectively. There was no difference (p = NS) in breast satisfaction, psychosocial well-being, physical well-being-chest, and sexual well-being between groups 1 and 5. Group 1 had higher satisfaction with breast (p < 0.01), psychosocial (p < 0.01) and sexual well-being (p < 0.01) when compared to groups 2 and 4. Group 1 had higher satisfaction with breasts (p < 0.01) compared to group 3. Group 4 did not differ in satisfaction with breasts, psychosocial, and sexual well-being, compared to groups 2 and 3. Group 4 had lower scores in all domains, compared to groups 1 and 5 (p < 0.01). No significant difference in QOL was found between groups 2 and 3. Preoperatively, immediate reconstruction patients had similar satisfaction with breasts, psychosocial well-being, and chest physical well-being, compared to non-breast plastic surgery patients. Aesthetic breast surgery patients demonstrate similar low scores in satisfaction with breasts, psychosocial well-being, and sexual well-being to those of patients prior to delayed breast reconstruction, or secondary salvage procedures.
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Affiliation(s)
- Eliana F R Duraes
- Cleveland Clinic, Cleveland, USA; University of Brasilia - Brasilia, Distrito Federal, Brazil.
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Breast Augmentation and Breast Reconstruction Demonstrate Equivalent Aesthetic Outcomes. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2016; 4:e811. [PMID: 27536490 PMCID: PMC4977139 DOI: 10.1097/gox.0000000000000824] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2015] [Accepted: 05/20/2016] [Indexed: 11/26/2022]
Abstract
BACKGROUND There is a perception that cosmetic breast surgery has more favorable aesthetic outcomes than reconstructive breast surgery. We tested this hypothesis by comparing aesthetic outcomes after breast augmentation and reconstruction. METHODS Postoperative images of 10 patients (cosmetic, n = 4; reconstructive, n = 6; mean follow-up, 27 months) were presented anonymously to participants who were blinded to clinical details. Participants were asked if they believed cosmetic or reconstructive surgery had been performed. Aesthetic outcome measures were quantified: (1) natural appearance, (2) size, (3) contour, (4) symmetry, (5) position of breasts, (6) position of nipples, (7) scars (1 = poor and 4 = excellent). Images were ranked from 1 (most aesthetic) to 10 (least aesthetic). Analyses included two-tailed t tests, Mann-Whitney U tests, and χ(2) tests. RESULTS One thousand eighty-five images were quantified from 110 surveys (99% response rate). The accuracy of identifying cosmetic or reconstructive surgery was 55% and 59%, respectively (P = 0.18). Significantly more of the top 3 aesthetic cases were reconstructive (51% vs 49%; P = 0.03). Despite this, cases perceived to be reconstructive were ranked significantly lower (5.9 vs 5.0; P < 0.0001). Mean aesthetic outcomes were equivalent regardless of surgery for 5 categories (P > 0.05), with the exception of breast position that improved after reconstruction (2.9 vs 2.7; P = 0.009) and scars that were more favorable after augmentation (2.9 vs 3.1; P < 0.0001). Age and nipple position (R (2) = 0.04; P = 0.03) was the only association between a demographic factor and aesthetic outcome. CONCLUSIONS Aesthetic outcomes after cosmetic and reconstructive breast surgery are broadly equivalent, though preconceptions influence aesthetic opinion. Plastic surgeons' mutually inclusive-reconstructive and aesthetic skill set maximizes aesthetic outcomes.
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Lee J, Bae Y, Jung JH, Kim WW, Hwang SO, Kwon TJ, Chung JH, Park HY, Lee S, Jung Y. Effects of Quilting Suture Interval on Donor Site Seromas After Breast Reconstruction With Latissimus Dorsi Muscle Flap: A Randomized Trial. Clin Breast Cancer 2016; 16:e159-e164. [PMID: 27364307 DOI: 10.1016/j.clbc.2016.05.017] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2016] [Revised: 03/30/2016] [Accepted: 05/30/2016] [Indexed: 11/15/2022]
Abstract
BACKGROUND Although breast reconstruction using a deep inferior artery perforator flap has been increasing, using a latissimus dorsi (LD) muscle flap is still the favored method for Asian female patients with breast cancer. However, because the incidence of donor site seromas has been relatively high, a quilting method on the donor cavity or insertion of drainage tube has been used to reduce the incidence and/or severity of postoperative seroma. We evaluated the effects of different intervals of quilting sutures on the postoperative drainage volume and components of seroma fluid. PATIENTS AND METHODS A total of 36 patients with breast cancer underwent partial or total mastectomy with LD flap reconstruction. They were randomized into 3 groups according to the interval of quilting sutures: nonquilting (n = 10), 6-cm quilting (n = 14), and 3-cm quilting (n = 12). The clinicopathologic factors and time to drain removal, drainage volume, frequency of aspiration, and serous fluid components were investigated. RESULTS No statistically significant differences were found in the clinicopathologic factors among the 3 groups. The time to drain removal was significantly shorter in the 6-cm quilting and 3-cm quilting groups than in the nonquilting group (P = .039 and P = .041, respectively). The total volume of drainage from the donor site was also decreased in the quilting groups (6-cm group, P = .046; 3-cm group, P = .021). The seroma components were not different among the 3 groups. CONCLUSION Performing quilting sutures on LD flap donor sites is an effective method to reduce the volume of postoperative seroma. The present findings showed that a 6-cm suture interval is appropriate.
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Affiliation(s)
- Jeeyeon Lee
- Department of Surgery, Kyungpook National University, School of Medicine, Daegu, Republic of Korea
| | - Youngtae Bae
- Department of Surgery, Pusan National University, School of Medicine, Busan, Republic of Korea
| | - Jin Hyang Jung
- Department of Surgery, Kyungpook National University, School of Medicine, Daegu, Republic of Korea
| | - Wan Wook Kim
- Department of Surgery, Kyungpook National University, School of Medicine, Daegu, Republic of Korea
| | - Seung Ook Hwang
- Department of Surgery, Kyungpook National University, School of Medicine, Daegu, Republic of Korea
| | - Taek Ju Kwon
- Department of Surgery, Kyungpook National University, School of Medicine, Daegu, Republic of Korea
| | - Jin Ho Chung
- Department of Surgery, Kyungpook National University, School of Medicine, Daegu, Republic of Korea
| | - Ho Yong Park
- Department of Surgery, Kyungpook National University, School of Medicine, Daegu, Republic of Korea.
| | - Seokwon Lee
- Department of Surgery, Pusan National University, School of Medicine, Busan, Republic of Korea
| | - Younglae Jung
- Department of Surgery, Pusan National University, School of Medicine, Busan, Republic of Korea
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