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Martini F, Meroni M, Scaglioni MF. The use of fibrin glue to stabilize and secure the lymphovenous anastomosis. Microsurgery 2024; 44:e31191. [PMID: 38798128 DOI: 10.1002/micr.31191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Revised: 03/27/2024] [Accepted: 05/10/2024] [Indexed: 05/29/2024]
Affiliation(s)
- Federica Martini
- Zentrum für Plastische Chirurgie, Pyramid Clinic, Zurich, Switzerland
| | - Matteo Meroni
- Zentrum für Plastische Chirurgie, Pyramid Clinic, Zurich, Switzerland
- Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | - Mario F Scaglioni
- Zentrum für Plastische Chirurgie, Pyramid Clinic, Zurich, Switzerland
- Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
- Department of Hand and Plastic Surgery, Luzerner Kantonsspital, Lucerne, Switzerland
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Lombardo GAG, Marrella D, Stivala A, Ciancio F, Musmarra I, Catalano F, Stagno D Alcontres F, Ranno R. Pedicle stabilization with fibrin sealant in DIEP flap breast reconstruction. Updates Surg 2024; 76:1041-1046. [PMID: 38091191 DOI: 10.1007/s13304-023-01711-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Accepted: 11/18/2023] [Indexed: 05/28/2024]
Abstract
Microsurgical procedures are nowadays routinely performed worldwide in reconstructive surgery. The deep inferior epigastric artery perforator (DIEP) flap has become the gold standard in breast reconstruction due to its excellent outcomes and lower donor site morbidity. However, complications, including flap failure, still occur in DIEP flap breast reconstruction. Often, according to our experience, these complications result from pedicle disorders, which can be attributed to postoperative mobilization. In the present study, we evaluated the efficacy and safety of using a fibrin sealant as a method for pedicle stabilization to prevent pedicle mobilization in the postoperative period. With our technique, after the flap insetting and microsurgical anastomosis, the pedicle was stabilized by applying a fibrin sealant (TISSEEL™) around and over the entire pedicle. Our study included a homogeneous series of 70 patients who received a delayed DIEP flap breast reconstruction. A retrospective study was conducted to evaluate this novel technique compared to the conventional method. In our experience, the fibrin glue allowed us to reduce the strain for correct pedicle positioning and all subsequent efforts to avoid displacements in the postoperative period. Our preliminary results suggest that this method may lead to a reduction in overall complications attributable to pedicle disorders.
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Affiliation(s)
- Giuseppe A G Lombardo
- Burn and Plastic, Reconstructive and Aesthetic Surgery, Azienda Ospedaliera Cannizzaro, Via Messina 829, Catania, Italy
- University Unikore of Enna, Piazza dell'Università, 94100, Enna, EN, Italy
| | - Domenico Marrella
- Department of Human Pathology, Plastic Surgery Unit, University of Messina, AOU G. Martino, Messina, Italy.
| | - Alessio Stivala
- Polyclinique Lyon Nord, Plastic and Reconstructive Surgery, Hand Surgery, 65 Rue Des Contamines, 69140, Rillieux-La-Pape, France
| | - Francesco Ciancio
- Burn and Plastic, Reconstructive and Aesthetic Surgery, Azienda Ospedaliera Cannizzaro, Via Messina 829, Catania, Italy
| | - Isidoro Musmarra
- Service de Chirurgie Plastique, Reconstructrice et Esthétique, Centre Hospitalier R. Ballanger, Boulevard Ballanger, 93600, Aulnay-Sous-Bois, France
| | - Francesca Catalano
- Breast Unit, Azienda Ospedaliera Cannizzaro, Via Messina 829, Catania, Italy
| | | | - Rosario Ranno
- Burn and Plastic, Reconstructive and Aesthetic Surgery, Azienda Ospedaliera Cannizzaro, Via Messina 829, Catania, Italy
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Beltramini GA, Rabbiosi D, Allevi F, Giannì AB, Biglioli F. The use of fibrin glue to stabilize geometry of free-flaps vascular pedicle. Oral Maxillofac Surg 2018; 22:113-114. [PMID: 29147799 DOI: 10.1007/s10006-017-0663-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Accepted: 10/11/2017] [Indexed: 06/07/2023]
Affiliation(s)
- Giada A Beltramini
- Maxillofacial Surgery and Dental Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano, 35, via Francesco Sforza, 20122, Milan, Italy.
| | - Dimitri Rabbiosi
- Maxillofacial Surgery Unit, ASST Santi Paolo e Carlo, Università degli Studi di Milano, Milan, Italy
| | - Fabiana Allevi
- Maxillofacial Surgery Unit, ASST Santi Paolo e Carlo, Università degli Studi di Milano, Milan, Italy
| | - Aldo B Giannì
- Maxillofacial Surgery and Dental Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano, 35, via Francesco Sforza, 20122, Milan, Italy
| | - Federico Biglioli
- Maxillofacial Surgery Unit, ASST Santi Paolo e Carlo, Università degli Studi di Milano, Milan, Italy
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