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Simultaneous Co-surgeon Deep Inferior Epigastric Perforator (DIEP) Flap Breast Reconstructions: Feasibility and
Christine S Wang1, Abdl-Rawf Al-Nowaylati2, Niki Matusko3
1Section of Plastic Surgery, Department of Surgery, Michigan Medicine, University of Michigan Health System, Ann Arbor, MI, USA.
Annals of Surgical Oncology
|April 15, 2024
Summary
Simultaneous co-surgeon bilateral deep inferior epigastric perforator (DIEP) flap breast reconstruction shows comparable complication rates to non-simultaneous approaches. This method may enhance patient access to care without compromising clinical outcomes.
Area of Science:
- Plastic Surgery
- Microsurgery
- Breast Reconstruction
Background:
- The co-surgeon model is beneficial in microvascular breast reconstruction.
- Simultaneous co-surgeon bilateral deep inferior epigastric perforator (DIEP) flap reconstructions are not extensively studied.
- This study investigates the efficacy and safety of simultaneous co-surgeon bilateral DIEP flaps.
Purpose of the Study:
- To evaluate the clinical outcomes of simultaneous co-surgeon bilateral DIEP flap breast reconstructions.
- To compare these outcomes with non-simultaneous reconstructions performed by the same co-surgeons.
- To determine if the simultaneous approach improves patient access to care.
Main Methods:
- Retrospective cohort study of 137 patients undergoing co-surgeon free-flap breast reconstruction over 38 months.
- Identified 64 patients for simultaneous bilateral DIEP flap reconstruction (study group) versus non-simultaneous (control group).
- Analyzed 90-day postoperative complications, operative time, ischemia time, and length of stay using statistical analyses.
Main Results:
- No significant differences in 90-day complications (flap loss, revision, re-admission) between simultaneous and non-simultaneous groups.
- Operative time was longer in the simultaneous group (540.5 vs. 443.5 min).
- Ischemia time was shorter in the simultaneous group (64.0 vs. 80.5 min).
Conclusions:
- Simultaneous co-surgeon bilateral DIEP flap reconstruction is not associated with increased complication rates.
- This approach may improve patient access to breast reconstruction surgery.
- The findings support the simultaneous co-surgeon model for bilateral DIEP flaps.
