Effect of supercharged pedicled rectus abdominis flap for breast reconstruction
10.3760/cma.j.issn.1671-0290.2024.05.004
- VernacularTitle:增压带蒂腹直肌皮瓣用于乳房再造的效果
- Author:
Jingjun ZHU
1
;
Liyi YANG
;
Zan LI
;
Dajiang SONG
Author Information
1. 内蒙古自治区包头市肿瘤医院 包头医学院附属肿瘤医院乳腺外科，包头 014030
- Keywords:
Breast neoplasms;
Pedicled myocutaneous flap;
Rectus abdominis flap;
Deep inferior abdominal artery;
Surpercharged;
Breast reconstruction
- From:
Chinese Journal of Medical Aesthetics and Cosmetology
2024;30(5):430-434
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the effect of pressurized pedicled rectus abdominis flap for breast reconstruction.Methods:A retrospective study was conducted to include 37 female patients with breast cancer who underwent immediate breast reconstruction using a pressurized pedicle rectus abdominis skin flap transplantation after surgery at the Department of Plastic and Reconstructive Surgery, Hunan Provincial Cancer Hospital from March 2019 to December 2022. The patients were aged 29-61 years, with an average age of (37.7±3.5) years. According to the preoperative imaging and ultrasound data, 17 patients were planned to complete immediate breast reconstruction with free inferior abdominal artery perforator flap transplantation, and the operation was adjusted to directly prepare a pedicled rectus abdominis flap with long inferior abdominal vessel pedicle according to the actual situation. In addition, 20 patients were scheduled to use pedicled rectus abdominis flap alone, and the operation was changed according to the actual situation. The flap was trimmed according to the condition of the affected area and immediate intraoperative fluorgraphy. After cutting off the vascular pedicle, the recipient area was placed, and the recipient blood vessels were selected for vascular anastomosis. After shaping, the donor and recipient areas were sutured. The survival of the skin flap was observed.Results:Intraoperative fluorescein angiography was used to determine the blood supply of the flap. It was found that 37 cases of pedicled rectus abdominis flaps had different degrees of blood supply disorders. The affected vessels in the specific anastomosis comprised the intrathoracic vessels (19 cases, 51.4%), the lateral thoracic arterial vein (10 cases, 27.0%), and anterior branches of the thoracic and dorsal vessels (8 cases, 21.6%). In 37 cases, the lateral abdominal wall vein was carried in the flap, 20 of which carried the lateral abdominal wall shallow vein, 17 cases carried the lateral abdominal wall shallow vein, six of which were extra anastomosed and superficial vein, and the actual utilization rate was 16.2%. The follow-up was 47 months, averaging 22.7 months. 37 patients had fair reconstructed breast appearance, good elasticity, and no flap contracture deformation. Only linear scar was left in the flap donor area with no effect on abdominal wall function.Conclusions:Pressurized rectus flap can improve the survival rate and surgical safety.
