Buried Autologous Breast Reconstruction: Outcomes and Technical Considerations.

Area of Science:

• Plastic Surgery
• Reconstructive Surgery
• Oncology

Background:

• Breast reconstruction aims to restore aesthetics and symmetry post-mastectomy.
• Free flap surgery is a common technique, but buried flaps present unique monitoring challenges.
• Venous flow couplers offer a potential solution for monitoring buried free flaps.

Purpose of the Study:

• To compare outcomes of buried versus non-buried free flaps in breast reconstruction.
• To evaluate the safety and reliability of venous flow couplers for monitoring buried flaps.
• To assess flap failure rates, complication incidence, and the number of procedures required.

Main Methods:

• Retrospective review of 322 free flap breast reconstructions (2013-2023).
• Comparison of buried (47.5%) and non-buried (52.0%) flap groups.
• Analysis of flap failure, complications, and procedural stages.

Main Results:

• No significant difference in flap failure rates between buried (2.0%) and non-buried (1.8%) groups.
• Buried flaps significantly reduced the number of procedures needed for reconstruction (52.2% single-stage vs. 25.5%).
• Venous flow couplers demonstrated high reliability, with no flap losses missed.

Conclusions:

• Buried free flap breast reconstruction is a safe and effective option.
• This technique significantly decreases the number of operations required for successful reconstruction.
• Venous flow couplers are a safe and reliable tool for monitoring buried free flaps.