Deep inferior epigastric artery perforator flap transferred for breast reconstruction salvage after failed tissue expander implantation
10.3760/cma.j.cn114453-20200705-00406
- VernacularTitle:扩张器置入失败后采用腹壁下动脉穿支皮瓣移植再造乳房
- Author:
Dajiang SONG
1
;
Zan LI
;
Xiao ZHOU
;
Yixin ZHANG
;
Xiaowei PENG
;
Bo ZHOU
;
Chunliu LYU
;
Peng WU
;
Yuanyuan TANG
Author Information
1. 湖南省肿瘤医院肿瘤整形外科，长沙 410008
- Keywords:
Breast neoplasms;
Breast reconstruction;
Perforator flap;
Deep inferior epigastric artery;
Soft tissue expander
- From:
Chinese Journal of Plastic Surgery
2021;37(7):719-725
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To present the authors’experience using a deep inferior epigastric artery perforator (DIEP) flap for the salvage of tissue expander implantation failed breast reconstruction.Methods:A retrospective study was conducted of all patients who underwent breast reconstruction salvaged by means of a DIEP flap because of failed tissue expander implantation in the Department of Oncology Plastic Surgery of Hunan Province Cancer Hospital from July 2016 to January 2019. Flap survival, breast shape, wound healing and abdominal wall function were reviewed.Results:A total of 13 patients, female, 28 to 53 years old, were included in this study. All the patients had undergone modified mastectomy and failed tissue expander implantation before, and the expanders were removed because of infection in 3 cases, the capsule contracture and displacement in 4 cases and patients feeling uncomfortable and refused prosthesis implantation in 6 cases. Unilateral reconstruction was performed in all cases, 8 cases of left breast and 5 cases of the right. Thirteen free DIEP flaps were harvested. The length, width and thickness of DIEP flap were (25.5 ± 0.6) cm, (12.6 ± 0.4) cm and (5.9 ± 0.7) cm respectively, and the length of vascular pedicle was (11.3 ± 0.4) cm. The average weight of the flap was 435 g (390-510 g). The average operation time was 440 min (390-560 min). The proximal end of internal mammary vessels were used as the recipient vessels in 6 cases, the proximal and distal end of internal mammary vessels were used as the recipient vessels in 4 cases, the thoracodorsal vessels in 2 cases and combined the thoracodorsal vessels and the proximal end of internal mammary vessels in 1 case. All flaps survived successfully. The average follow-up period was 16.5 months (range, 12-39 months). The appearance and texture of reconstructed breast were good, and there was no flap contracture and deformation. Only concealed linear scar was left in the donor site. The motor function of abdominal wall was not limited.Conclusions:Salvaging failed tissue expander implantation breast reconstruction using DIEP flap is safe and efficient, with satisfying breast appearance and low complication rate.
