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Risk Factor Analysis for Flap and Donor Site Related Complications in 1274 DIEP Flaps - Retrospective Single Center
Chirurgia (Bucharest, Romania : 1990)
|May 8, 2021
Summary
Deep Inferior Epigastric Perforator (DIEP) flap surgery is a safe and effective method for breast reconstruction after mastectomy. Higher BMI and smoking are risk factors for complications, but age and prior radiation therapy are not significant concerns.
Area of Science:
- Plastic Surgery
- Oncology
- Reconstructive Surgery
Background:
- Breast cancer is a leading global cancer in women.
- Mastectomy is common in Germany, necessitating breast reconstruction, particularly after radiation.
- The Deep Inferior Epigastric Perforator (DIEP) flap is the standard for autologous reconstruction with low complications.
Purpose of the Study:
- To assess the safety of DIEP flap surgery for breast reconstruction.
- To identify risk factors for flap edge and fat necrosis.
- To analyze outcomes in a large retrospective series.
Main Methods:
- Retrospective analysis of 1274 DIEP flaps in 1124 patients (2004-2014).
- Evaluation of risk factors: age, BMI, smoking, chemotherapy, radiotherapy, comorbidities.
- Mean follow-up period of 24 months.
Main Results:
- Total flap loss rate was 0.6% across 1274 reconstructions.
- Higher BMI and smoking correlated with increased complication rates.
- No significant increase in complications for elderly patients, diabetics, or those with prior chemo-/radiotherapy.
Conclusions:
- DIEP flap surgery is a reliable breast reconstruction technique with a low complication rate.
- Patient-specific risk factors like BMI and smoking status are crucial for prognosis.
- Consideration of risk factors aids in achieving satisfactory long-term reconstructive outcomes.
