Simultaneous Microsurgery During Bilateral Autologous Breast Reconstruction Reduces Ischemia Time Without Increasing...

Area of Science:

• Microsurgery
• Plastic Surgery
• Breast Reconstruction

Background:

• Bilateral DIEP flap reconstruction typically involves consecutive microsurgical anastomoses.
• A co-surgeon model with loupe magnification enables simultaneous microsurgery.
• The impact of simultaneous versus consecutive techniques on outcomes requires assessment.

Purpose of the Study:

• To evaluate the implications of simultaneous versus consecutive microsurgery.
• To assess effects on ischemia time and postoperative outcomes in bilateral DIEP flap reconstruction.

Main Methods:

• Retrospective chart review of bilateral DIEP flap breast reconstruction patients (2017-2023).
• Classification of microsurgery as simultaneous (≥10 min overlap) or consecutive (<10 min overlap).
• Analysis of demographics, ischemia time, operating time, complications, LOS, and MME.

Main Results:

• Simultaneous microsurgery significantly reduced total ischemia time (111 min vs. 147 min; p < 0.001).
• No significant differences observed in total operating time, complications, 90-day events, LOS, or MME.
• Multivariate regression confirmed reduced ischemia time without adverse effects.

Conclusions:

• Simultaneous microsurgery in bilateral DIEP flap reconstruction effectively reduces total ischemia time.
• This technique does not increase postoperative complications, hospital length of stay, or pain management needs.
• Simultaneous microsurgery is a viable alternative to consecutive approaches for bilateral DIEP flap reconstruction.