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Immediate versus secondary DIEP flap breast reconstruction: a multicenter outcome study
L Prantl1, N Moellhoff2, U von Fritschen3
1Centre of Plastic, Aesthetic, Hand and Reconstructive Surgery, University of Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany.
Archives of Gynecology and Obstetrics
|September 8, 2020
Summary
Immediate breast reconstruction (IBR) offers comparable flap outcomes to delayed breast reconstruction (DBR) without increasing complications. IBR leads to faster mobilization and shorter hospital stays, supporting its growing popularity.
Area of Science:
- Plastic Surgery
- Oncology
- Health Economics
Background:
- Immediate breast reconstruction (IBR) is increasingly favored over delayed breast reconstruction (DBR).
- Studies indicate IBR does not negatively impact cancer recurrence or patient survival.
- IBR offers potential benefits like improved aesthetics, reduced psychological distress, and lower costs.
Purpose of the Study:
- To compare outcomes and complications between immediate breast reconstruction (IBR) and delayed breast reconstruction (DBR).
- To analyze data from the largest European database for free DIEP-flap breast reconstructions.
Main Methods:
- A retrospective analysis of 4577 free DIEP-flap breast reconstructions in 3926 female patients across 22 German centers.
- Patients were categorized into IBR and DBR groups.
- Surgical complications and patient outcomes were systematically compared between the two groups.
Main Results:
- No significant differences were observed in partial or total flap loss rates between IBR and DBR groups.
- The IBR group showed a significantly lower rate of revision surgery (7.7% vs. 9.8%).
- IBR patients experienced earlier postoperative mobilization (82.1% mobilized on day 1) and shorter hospital stays (mean 7.3 days vs. 8.9 days).
Conclusions:
- Immediate breast reconstruction (IBR) is a feasible option and not associated with increased complications or adverse flap outcomes.
- The findings support the increasing trend towards IBR, highlighting its efficiency.
- Reduced hospitalization associated with IBR is particularly significant in the context of healthcare economic pressures.
