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.
Resumen
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.
Por qué esto importa para la hirudoterapia
Este estudio analizó de forma prospectiva 292 casos de reconstrucción mamaria con colgajo DIEP unilateral para identificar los factores de riesgo relacionados con las perforantes asociados a complicaciones vinculadas a la perfusión, encontrando que la distancia más corta entre la perforante y el borde del colgajo (umbral crítico de 42,5 mm) fue un fuerte predictor de complicaciones. El trabajo aborda la perfusión quirúrgica de los colgajos, un ámbito en el que las sanguijuelas medicinales se despliegan a veces como terapia de rescate para la congestión venosa, aunque el resumen en sí no menciona sanguijuelas ni hirudoterapia. La relevancia para el dominio de la ASH es, por lo tanto, estrictamente indirecta: el estudio ilumina las complicaciones de perfusión que la hirudoterapia a veces es convocada a manejar, pero no aporta datos sobre el uso de sanguijuelas, sobre los componentes del secretoma de la sanguijuela ni sobre desenlaces relacionados con la hirudoterapia. No puede extraerse ninguna conclusión defendible y específica sobre sanguijuelas a partir de este resumen.
Citación
Perforator-Related Risk Factors for Perfusion-Related Complications in DIEP Flap Breast Reconstruction.
Suhail Ds et al. · JPRAS open, 2025
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Añadido a la biblioteca ASH: May 28, 2026 · Última actualización del sitio: June 18, 2026