Immediate postoperative complications in DIEP versus free/muscle-sparing TRAM flaps Journal Article
| Authors: | Chen, C. M.; Halvorson, E. G.; Disa, J. J.; Mccarthy, C.; Hu, Q. Y.; Pusic, A. L.; Cordeiro, P. G.; Mehrara, B. J. |
| Article Title: | Immediate postoperative complications in DIEP versus free/muscle-sparing TRAM flaps |
| Abstract: | BACKGROUND: The deep inferior epigastric perforator (DIEP) flap is a major advance in breast reconstruction, but many surgeons are reluctant to use it because of concerns about a higher flap loss rate when compared with free/muscle-sparing transverse rectus abdominis myocutaneous (TRAM) flaps. Previous studies, however, have not statistically analyzed the relationship of patient characteristics to outcome. This study evaluates the authors' institutional experience with immediate postoperative complications following DIEP and free/muscle-sparing TRAM flaps. METHODS: Results of 200 consecutive free/muscle-sparing TRAM and DIEP flaps performed by two surgeons at a single institution between 2003 and 2005 were reviewed using a prospectively maintained database. The incidence of flap complications was compared. Patient demographics, procedure type, diagnosis, adjuvant treatment, and complications were recorded. Outcome variables included total and partial flap loss, infection, seroma, hematoma, wound-healing problems, fat necrosis, and mastectomy flap necrosis. RESULTS: One hundred forty-three patients were treated with 159 free/muscle-sparing TRAM flaps and 41 DIEP flaps. The demographics of the two groups were statistically similar. No statistically significant differences were noted in total or partial flap loss. CONCLUSIONS: In the authors' series, the use of the DIEP flap did not result in more postoperative flap-related complications when compared with the free/muscle-sparing TRAM flap. Furthermore, no patient characteristics were statistically associated with a more successful result. The authors conclude that in patients whose anatomy reveals perforators of adequate size, the DIEP flap is a safe and reliable procedure for breast reconstruction. ©2007American Society of Plastic Surgeons. |
| Keywords: | adult; aged; middle aged; surgical technique; retrospective studies; plastic surgery; surgical flaps; comparative study; methodology; demography; breast reconstruction; transplantation; vascularization; mammaplasty; data base; graft necrosis; retrospective study; time; time factors; postoperative complication; postoperative complications; graft failure; statistical significance; surgeon; comorbidity; postoperative infection; deep inferior epigastric perforator flap; transverse rectus abdominis musculocutaneous flap; hematoma; seroma; wound healing impairment; normal human; rectus abdominis; rectus abdominis muscle; fat necrosis; outcome variable; epigastric artery; epigastric arteries |
| Journal Title: | Plastic and Reconstructive Surgery |
| Volume: | 120 |
| Issue: | 6 |
| ISSN: | 0032-1052 |
| Publisher: | Lippincott Williams & Wilkins |
| Date Published: | 2007-11-01 |
| Start Page: | 1477 |
| End Page: | 1482 |
| Language: | English |
| DOI: | 10.1097/01.prs.0000288014.76151.f7 |
| PUBMED: | 18040176 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | --- - "Cited By (since 1996): 33" - "Export Date: 17 November 2011" - "CODEN: PRSUA" - "Source: Scopus" |
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