Skin-Reducing Mastectomy in Immediate Reconstruction: How to Limit Complications and Failures
| العنوان: | Skin-Reducing Mastectomy in Immediate Reconstruction: How to Limit Complications and Failures |
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| المؤلفون: | Lolita Pechevy, Emmanuel Delay, Pierre-Luc Vincent, Raphael Carloni, G. Toussoun, Samia Guerid |
| المصدر: | Aesthetic Surgery Journal. 37:665-677 |
| بيانات النشر: | Oxford University Press (OUP), 2017. |
| سنة النشر: | 2017 |
| مصطلحات موضوعية: | Adult, medicine.medical_specialty, Mammaplasty, Breast surgery, medicine.medical_treatment, 030230 surgery, Surgical Flaps, Breast Diseases, Necrosis, 03 medical and health sciences, Postoperative Complications, 0302 clinical medicine, Breast cancer, Risk Factors, Photography, medicine, Humans, Breast, Treatment Failure, Mastectomy, Retrospective Studies, Skin, Radiotherapy, business.industry, Wound dehiscence, Smoking, Retrospective cohort study, Hypertrophy, General Medicine, Middle Aged, medicine.disease, Surgery, Radiation therapy, 030220 oncology & carcinogenesis, Superficial Back Muscles, Female, Implant, Breast reconstruction, business |
| الوصف: | Background In hypertrophic and/or very ptotic breasts, skin-reducing mastectomy (SRM) is challenging and the risk of complications is high. Few publications have reported the use of an autologous latissimus dorsi flap (ALDF) in this indication. Most studies opt for implant reconstructions, with a high failure rate. Objectives We aimed to identify and present the technical refinements that reduce the risk of reconstruction failure in patients with hypertrophic and/or ptotic breasts with breast cancer or at risk of breast cancer after SRM with immediate breast reconstruction (IBR) utilizing an ALDF. Methods Our retrospective study, covering a period of 18 years, included a series of 60 patients with hypertrophic and/or ptotic breasts who underwent 67 SRM and IBR procedures utilizing an ALDF. The complications were recorded and the risk factors analyzed. Results Sixty-seven SRMs were reviewed. Forty-nine procedures were performed with an inverted-T scar technique and 18 with a vertical scar technique. The nipple-areola complex (NAC) was preserved in 10 cases. There were eight (11.9%) cases of minor mastectomy flap necrosis after skin-reducing reconstructions, 16 (23.8%) wound dehiscences, no infections, no breast seromas, and no reconstruction failures. Smoking increased the risk of minor mastectomy flap necrosis (P = 0.048) and wound dehiscence (P = 0.002). Previous radiotherapy was associated with minor mastectomy flap necrosis (P = 0.001). Conclusions The use of an ALDF together with technical refinements that preserve the vascular supply of the skin envelope leads to successful IBR with consistently good aesthetic results. Above all, it avoids failure of the reconstruction in very large or ptotic breasts. Level of Evidence 4 |
| تدمد: | 1527-330X 1090-820X |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::fc699babb0fa1f175250de8c7e082a67 https://doi.org/10.1093/asj/sjw258 |
| حقوق: | OPEN |
| رقم الأكسشن: | edsair.doi.dedup.....fc699babb0fa1f175250de8c7e082a67 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 1527330X 1090820X |
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