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Related Concept Videos

Flail Chest-II01:26

Flail Chest-II

160
Managing flail chest, a condition characterized by a segment of the chest wall moving independently from the rest of the thoracic cage, requires a comprehensive approach. It includes a thorough assessment of the patient's condition, a diagnostic evaluation to determine the extent of the injury, and the implementation of appropriate medical interventions tailored to the individual's needs.
Assessment:
1. Clinical Evaluation:
History:
160
Flail Chest-I01:24

Flail Chest-I

141
Overview of Flail Chest
Flail chest is a severe and potentially life-threatening condition characterized by the fracture of three or more adjacent ribs in multiple places. It is most commonly caused by direct impacts and trauma, such as motor vehicle accidents or injuries from a steering wheel impact. It can also occur due to falls in elderly individuals with osteoporosis, or assaults involving sharp objects.
Pathophysiology
The pathophysiology of flail chest is complex, involving fractures of...
141

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Related Experiment Video

Updated: Jun 8, 2025

Endoscopic Bilateral Nipple-sparing Mastectomy via a Single Axillary Incision with Immediate Pre-pectoral Implant-based Breast Reconstruction
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Chest wall perforator flaps are safe and can decrease mastectomy rates in breast cancer surgery: multicentre cohort

Andreas Karakatsanis1,2, Farid Meybodi3,4, Eirini Pantiora1,2

  • 1Department for Surgical Sciences, Uppsala University, Uppsala, Sweden.

The British Journal of Surgery
|November 1, 2024
PubMed
Summary
This summary is machine-generated.

Chest wall perforator flaps offer a viable alternative to mastectomy in breast cancer conservation. This study shows the procedure is safe and effective in experienced centers, with low complication and recurrence rates.

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Area of Science:

  • Oncoplastic surgery
  • Breast reconstruction
  • Surgical oncology

Background:

  • Chest wall perforator flaps are increasingly used in oncoplastic breast conservation as an alternative to mastectomy.
  • Standardization of patient selection, techniques, and outcomes for these flaps is lacking.
  • This international multicenter study addresses this gap by exploring practice patterns and outcomes in high-volume centers.

Purpose of the Study:

  • To investigate practice patterns and outcomes of chest wall perforator flaps in oncoplastic breast conservation.
  • To evaluate the safety and efficacy of these flaps as an alternative to mastectomy.
  • To contribute to the standardization of techniques and patient selection.

Main Methods:

  • An international multicenter collaborative study involving high-volume centers in Sweden, the UK, and Australia.
  • Prospective documentation of patient selection rationale and surgical outcomes for chest wall perforator flaps.
  • Analysis of data from 603 patients with pre-invasive and invasive breast cancer.

Main Results:

  • 603 patients analyzed; 67.7% received flaps to avoid mastectomy.
  • Low overall complication rate (8.6%), with most being minor (Clavien-Dindo grade I).
  • Low re-excision rate (15.9%), minimal mastectomy conversion (1.5%), and no flap losses. Recurrence rates: local 1.9%, distant 4.9%; breast cancer mortality 1.7%.

Conclusions:

  • Chest wall perforator flaps are a valuable option for breast conservation, enabling more women to avoid mastectomy.
  • The procedure is safe and effective when performed by experienced surgeons in suitable patients.
  • Further standardization in patient selection and technique is warranted.