Perforator-Related Risk Factors for Perfusion-Related Complications in DIEP Flap Breast Reconstruction.
Research article published in JPRAS open (2025)
Abstract
INTRODUCTION: Despite the advancements in deep inferior epigastric artery perforator (DIEP) flap breast reconstruction, perfusion-related complications (PRCs) remain a concern. Such complications can negatively impact the aesthetic outcome, necessitate revisional surgery and delay adjuvant chemotherapy and radiotherapy. The aim of this study was to investigate the impact of perforator diameter, perforator row, and the shortest distance between the perforator and flap edge on the development of PRCs in DIEP flap breast reconstruction. METHODS: This cohort study prospectively analysed the stored data for consecutive patients who underwent unilateral DIEP flap breast reconstruction from January 2008 to January 2023. Variables with p<0.25 in univariate analysis were included in multivariate logistic regression analysis to identify the risk factors for PRCs. p<0.05 was deemed statistically significant. Receiver operating characteristic (ROC) curve analysis was conducted to identify the critical distance between the perforator and flap edge distinguishing the PRCs. RESULTS: V Overall, 292 cases of unilateral DIEP flap breast reconstruction were identified, with a mean patient age of 52.6 years. PRCs occurred in 72 cases (24.7%). Multivariate logistic regression identified the shortest distance between the perforator and flap edge that has a significant impact on PRC incidence. ROC curve analysis found the critical shortest distance between the perforator and flap edge distinguishing PRCs to be 42.5 mm. CONCLUSIONS: This study showed that the shortest distance between the perforator and flap edge is a strong predictor for PRCs in DIEP flap breast reconstruction. As several perforator characteristics are considered when designing and performing DIEP flap breast reconstruction, these findings can guide surgeons in this decision-making process.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Zusammenfassung
Despite the advancements in deep inferior epigastric artery perforator (DIEP) flap breast reconstruction, perfusion-related complications (PRCs) remain a concern. Such complications can negatively impact the aesthetic outcome, necessitate revisional surgery and delay adjuvant chemotherapy and radiotherapy.
Warum dies für die Hirudotherapie relevant ist
Diese Studie analysierte prospektiv 292 Fälle von unilateraler DIEP-Lappen-Brustrekonstruktion, um perforatorbezogene Risikofaktoren für perfusionsbedingte Komplikationen zu identifizieren, und fand, dass die kürzeste Distanz zwischen dem Perforator und dem Lappenrand (kritischer Schwellenwert 42,5 mm) ein starker Prädiktor für Komplikationen war. Die Arbeit befasst sich mit der chirurgischen Lappenperfusion, einem Bereich, in dem medizinische Blutegel gelegentlich als Salvage-Therapie bei venöser Stauung eingesetzt werden, obwohl das Abstract selbst Blutegel oder Hirudotherapie nicht erwähnt. Die Relevanz für den ASH-Bereich ist daher strikt indirekt: Die Studie beleuchtet die Perfusionskomplikationen, deren Behandlung manchmal der Hirudotherapie zufällt, liefert jedoch keine Daten zur Verwendung von Blutegeln, zu Komponenten des Blutegelsekretoms oder zu Ergebnissen im Zusammenhang mit der Hirudotherapie. Aus diesem Abstract lässt sich keine vertretbare blutegelspezifische Schlussfolgerung ziehen.
Zitation
Perforator-Related Risk Factors for Perfusion-Related Complications in DIEP Flap Breast Reconstruction.
Suhail Ds et al. · JPRAS open, 2025
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