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Breast sensation recovery after neurotized deep inferior epigastric perforator reconstruction
Isis Scomacao MD, Eliana F.R. Duraes MD, PhD, Cagri Cakmakoglu, Humzah A. Quereshy BA, Graham Schwarz MD, Risal Djohan, MD
Cleveland Clinic
2019-02-15
Presenter: Isis Scomacao
Affidavit:
Steven Bernard
Director Name: Steven Bernard
Author Category: Fellow Plastic Surgery
Presentation Category: Clinical
Abstract Category: Breast (Aesthetic and Recon.)
Purpose: To evaluate breast sensation outcomes after combined nerve conduit and allograft in deep inferior epigastric perforator (DIEP) reconstructions.
Methods: Dynamic and static sensation recovery tests were performed in all breast quadrants of consecutive patients that underwent deep inferior epigastric perforator reconstructionin with neurotizatized (group 1) and non-neurotized DIEP reconstructions (group 2). Demographics information, surgical details, and post-operative complications were collected.
Results: A total of 74 patients (96 breasts) underwent this technique since June/2016: 46 breasts from group 1, and 15 from group 2. The groups had similar age, BMI, smoking status, history of radiation therapy and timing of reconstruction. No difference was found for complications and reoperation between groups. The mean time interval between the surgery, first, and second tests were similar in groups 1 and 2. Thresholds on the first and second recovery tests were statistically similar. Compared to group 2, group 1 had 38.46% of the total areas evaluated (static and dynamic) with better sensation thresholds. On the second round of sensation tests, the clinical difference between the groups was more evident with better sensation thresholds for the neurotized group, 96.15% of the areas tested (static and dynamic).
Conclusion: There is a positive trend for breast sensation recovery after reconstruction with neurotized deep inferior epigastric perforator flaps. Nerve regeneration takes time to be achieved and a longer follow up is necessary to evaluate the final sensation recovery.
