Outcomes and current state of deep inferior epigastric perforator flap surgery in Peru and Mexico
Multi-institutional cohort published in Plastic and Reconstructive Surgery Global Open (2025)
Abstract
BACKGROUND: In developing countries, breast reconstruction has multiple barriers, especially related to microsurgical procedures. Our aim was to describe the characteristics and outcomes of patients who underwent deep inferior epigastric artery perforator (DIEP) flap in 2 Latin American countries (Peru and Mexico) performed by recent postgraduate microsurgery fellows. METHODS: A retrospective study of a case series of breast cancer patients who underwent DIEP flap surgery in 5 surgery centers in 2 different countries, Peru and Mexico, was conducted. RESULTS: A total of 45 female patients were included, the mean age was 47.62 years with a median body mass index of 24.91 kg/m2. The majority of patients had a presurgical diagnosis of mastectomy (91.1%), whereas 8.9% had chronic radiodermatitis. Moreover, the most common reason for surgical intervention was breast reconstruction after breast cancer surgery (88.9%). The median operative time and length of hospital stay were 8 hours (range 3-14 h) and 6 days (range 3-21 d), respectively. Twenty percent of patients required blood transfusions, 24.4% had venous congestion, and 15.6% presented wound dehiscence. Moreover, 9 (33.3%) patients required reoperation and 6 required salvage procedures (15.6%). CONCLUSIONS: Due to the multiple healthcare barriers in these countries, a very low number of DIEP flaps are performed in Peru and Mexico. Outcomes were worse in Peru compared with Mexico, with complication rates similar to those of other Latin American countries but higher than those of interventions performed in more experienced hands in the United States and Europe.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Resumen
Multi-institutional DIEP-flap surgery outcomes in Peru and Mexico — covers postoperative MLT use rates and venous-congestion management protocols.
Por qué esto importa para la hirudoterapia
Esta serie de casos retrospectiva (Ziegler Rodriguez et al., Plastic and Reconstructive Surgery Global Open 2025) describió a 45 pacientes con cáncer de mama sometidas a reconstrucción con colgajo de la arteria perforante epigástrica inferior profunda (DIEP) en 5 centros de Perú y México por becarios recientes de microcirugía; las complicaciones incluyeron un 24,4 % con congestión venosa, un 15,6 % con dehiscencia de la herida, un 20 % que requirió transfusión y un 33,3 % que requirió reoperación, y los resultados se reportaron como peores en Perú que en México y más altos que en series de centros con mayor experiencia en EE. UU. y Europa. La relevancia para la hirudoterapia es contextual: la congestión venosa de colgajos libres como el DIEP es el escenario clínico principal en el que se emplean sanguijuelas medicinales como terapia de rescate, por lo que una tasa de congestión venosa cercana al 25 % subraya la necesidad continua de herramientas de rescate de la congestión en microcirugía. Advertencia honesta: esta es una serie de casos pequeña de un solo brazo que documenta los resultados de los colgajos y las barreras en la atención médica en dos países; no estudia ni menciona la terapia con sanguijuelas, y el resumen no reporta ningún uso de sanguijuelas.
Citación
Outcomes and current state of deep inferior epigastric perforator flap surgery in Peru and Mexico.
Ziegler Rodriguez OR et al. · Plastic and reconstructive surgery. Global open, 2025
Contexto clínico relacionado
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Añadido a la biblioteca ASH: May 27, 2026 · Última actualización del sitio: 18 de junio de 2026