<< Back to the abstract archive
Sensory outcomes of breast free flap neurotization using allograft
Diana Carrau MD, Amanda Carraher PA-C, Sumanas Jordan MD, Matthew Chetta MD
The Ohio State University
2019-02-15
Presenter: Diana Carrau MD
Affidavit:
All coauthors appropriately participated in all aspects of this project. Diana Carrau has participated in greater than 50% of the study design, data acquisition, data analysis, and abstract proposal. I support the submission of this abstract.
Director Name: Greg Pearson MD
Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: Breast (Aesthetic and Recon.)
Increased patient expectations have inspired investigation into whether sensation after autologous breast reconstruction is improved with nerve coaptation. The Axogen RANGER study is a multicenter registry of AvanceŽ nerve allograft. To date, our group has performed the greatest number of autologous breast free flap neurotizations with nerve allograft. We report preliminary data for recovery of sensation in autologous post mastectomy breast reconstruction after nerve coaptation with nerve allograft.
Neurotizations were performed to the third or fourth intercostal nerve by coaptation to the abdominally based autologous free flap donor nerve with AvanceŽ nerve allograft. Demographics, surgical details, and postoperative sensory outcomes were recorded. Recovery of sensation to nine previously described areas of the reconstructed breast was measured with Semmes Weinstein monofilaments at approximately 3, 6, and 12 months postoperatively.
To date, we have enrolled 35 patients. Thirteen flaps have greater than 5 months of follow-up. Of these, 90% of neurotized breasts recovered sensation compared with 33% of non-neurotized breasts. The average number of areas that recovered sensation was 2 out of 9 per neurotized breast compared to 1 out of 9 in the control group. The average weighted filament that neurotized breasts appreciated postoperatively was 5.63, indicating sensation to deep pressure.
We present our data and surgical technique for performing neurotized autologous breast reconstruction with nerve allograft. Our early data demonstrates that recovery of sensation after autologous post mastectomy breast reconstruction is improved after coaptation with nerve allograft and suggests earlier recovery as well as greater area of recovered sensation.
